膀胱全摘除術後にみられた上部尿路移行上皮癌の検討

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1975～1990年の間に原発性膀胱癌100例,上部尿路癌(腎盂尿管癌)13例,前二者合併5例,計118例に治療を行った.原発性膀胱癌患者35例で膀胱全摘除術を行った.膀胱癌治療後に上部尿路癌が続発した4例は全て膀胱全摘除術後にのみ発見された.3例は膀胱全摘除術前に多発膀胱腫瘍があり,長期間の膀胱保存的治療後に再発腫瘍があった.他は原発性膀胱病変に膀胱全摘除術が行われたFrom 1975 to 1990, we treated 118 patients with urinary epithelial cancer, including 100 with primary bladder cancer, 13 with primary upper urinary tract cancer, and 5 with both diseases. Thirty-five patients with primary bladder cancer underwent total cystectomy. Upper urinary tract urothelial cancer developed in 4 patients (4.0%) and was detected only after cystectomy. Three patients had multiple bladder tumors before cystectomy and recurrent tumors under long-term bladder-preserving treatment. The other patient had had cystectomy for the primary bladder lesion. Our present policy is to perform urinary cytology once a month and intravenous urography once a year in patients with bladder cancer for early detection of secondary upper urinary tract cancer.