篇名 | Primary Carcinoma of Urinary Bladder |
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卷期 | 2:4 |
並列篇名 | 原發性膀胱癌 |
作者 | 謝德生 、 陳世乾 、 楊緒棣 、 陳淳 、 丘袓毅 |
頁次 | 592-599 |
關鍵字 | bladder transitional cell carcionoma 、 bladder squamous cell carcinoma 、 TSCI |
出刊日期 | 199112 |
自1977年至1989年間,有303位原發性膀胱癌病人在台大醫院泌尿科接受初次診斷及治療,男女比例為3.4:1,其中移行上皮細胞癌有268例(88.4%),鱗狀上皮細胞癌有20例(6.6%),腺癌有12例(4.0%),未分化上皮癌3例(1.1%)。91%病人有無痛性血尿症狀,而血尿時間之長短和膀胱癌之分期之間並無統計學上的相關性。五年存活率在移行上皮細胞癌為66.4%,鱗狀上皮細胞癌19.5%,腺癌18.5%,移行上皮細胞癌五年存活率,依癌細胞分期為A期85.5%,B期57.6%, C期23.8%,D期0%;按分化程度分級為:第一級90.3%,第二級51.8%,第三及第四級為43.8%。年輕人(35歲)的移行上皮細胞癌分期較低,預後也較好。膀胱化學藥物灌注治療可以有效地預防膀胱腫瘤的復發;至於Thiotepa 和Adriamycin兩者的預防效果,在統計上並無顯著差異。作者也特別注意到來自嘉義縣及台南縣的病人,其病理分期較高,預後也較差。1984年至1988年間,衛生署的生命統計報告也指出,該兩縣的膀胱癌年平均死亡率為台灣地區的2.5倍,此一現象值得進一頻研究探討。
We report the experience of 303 bladder concers initially treated at the department of Urology, National Taiwan University Hospital in 1977-1989. The male to female ratio was 3.4:1. Among 303 bladder cancers, 268(88.4%) cases were transitional cell carcinoma (TCC); 20(6.6%) cases squamous cell carcinoma. Painless gross hematuria (91%of cases) was the most frequently presenting symptom. There was no relationship be tween duration of hematruria and stage of bladder cancer. Younger patients (<35 y/o) had lower stage of bladder TCC with better prognosis. The 5-year observed survival rate of TCC was 66.4%; SCC 19.5%; and adenocarcinoma 18.5% respectively. For TCC, the 5-year survuival rate of stage a disease was 85.5%;stage B 57.6%; stage C 23.8%; and stage D 0%. The 5-year survival rate of TCC grade-I was 97.8%;grade-Ⅱ 78.6%; grade-Ⅲ/Ⅳ 44.6%. The 5-year disease free rate of TCC stage A grade-∣ was 90.3%; grade-Ⅱ 51.8%; grade-Ⅲ/Ⅳ 43.8%. The 5-year disease ofree rate of superficial bladder TCC patients with prophylatic intravesical chemotherapy was 64.5%; while patients without prophylaxis was 39.9% (P<0.05). Abnormally high stage of bladder cancer was noted in the patients who came from Chia-Yi and Tai-Nan district where a perpheral vascular disease called “black foot disease” is endemic now.