研究目的：腎盂癌是第二常見的成人泌尿生殖系統惡性腫瘤。我們報告近年來在本 院治療這個疾病的臨床經驗。材料與方法：自1992年7月至2000年，在本院診斷為腎 盂腫瘤的病患，作一回顧性的研究。對疾病的分級、分期、腫瘤的部位加以分析。手術 方式及後續追縱的結果也一併討論。結果：共有49位患有腎盂腫瘤的病患在本科治療。 總共有53個腎臟有腎盂腫瘤。平均年齡為64.6歲(25至81歲）。性別方面有25位男性 及24位女性。左、右侧腎戚被侵犯的機率相同。所有單侧的腎盂腫瘤的病患都接受標 準的腎臟輸尿管及膀胱袖口切除。其中4位有雙侧腎盂腫瘤的病患其第二侧則接受經皮 穿腎腎臟鏡腫瘤切除。除了 1位是鱗狀上皮癌之外，其餘都是移行上皮癌。癌症分期為 Ta期 7 位(13.2%)、T1 期 15 位(28.3%)、T2 期 B 位(24.5%)、T3 期 12 位(22.6%)、M+期
2位(3.8%)以及因為經皮穿腎腎臟鏡腫瘤切除取得標本而無法列明分期的4位。癌症分 級則為第1級I2位02；2.6%)、第2級32位（60.4%)及第3級9位（17.0%)。平均追跛時間 為46.7個月（16至93個月）。13位病患在追蹤時發現癌症進展。T2期的病患有16.7%發 現有遠端轉移、T3期也有16.7%遠端轉移》追蹤時發現有10位病患因癌病死亡。結論： 腎盂腫瘤分期及分級較高的病患較容易有癌病進展。根除性的切除病灶以減少局部復發 的機會是很重要的。為了減少癌病的進展，密切的追縱是否有局部復發及對其他部位的 移行上皮的定期檢查是很重要的。對於本研究的病患需要更長期的追蹤以了解5年甚至 10年的存活率。

Background and Purpose: Cancer of the renal pelvis is the second most common malignancy of the genitourinary system of adults in Taiwan. We report our experiences in treating this disease entity over nearly 8 years in our hospital. Materials and Methods: We retrospectively reviewed the charts of patients who were diagnosed with renal pelvis cancer between July 1992 and March 2000. The grade, stage, and side on which the tumor was found were analyzed. The operating procedures and the follow-up outcomes were also analyzed. Results： In total, 49 patients with a renal pelvis tumor were treated in our department, involving 53 renal units. The mean age of the patients was 64.6 (range, 25-81) years. There were 25 male and 24 female patients. All patients with unilateral renal pelvis tumor were treated with a standard nephroureterectomy with excision of the bladder cuff. Four patients with bilateral renal pelvis involvement underwent percutaneous nephroscopic resection of the tumor on the second side. Only 1 patient had squamous cell carcinoma, while the others all had transitional cell carcinoma based on the pathology reports. The stages of the tumors when diagnosed were Ta in 7 (13.2%) patients, T1 in 15 (28.3%) patients, T2 in 13 (24.5%) patients, T3 in 12 (22.6%) patients, M+ in 2 (3.8%) patients, and Indeterminate due to the specimens being obtained through percutaneous resection in 4 (7.5%) patients. The grades of the tumors were 12 (22.6%) patients with grade I，32 (60.4%) patients with grade II，and 9 (17.0%) patients with grade III. The mean follow-up period was 467 (range, 16-93) months. Thirteen patients presented with tumor progression during follow-up. Distant metastasis was found in 16.7% of patient with stage T2 and T3 tumors. Ten patients (xx%) died due to the tumor during follow up. Conclusions： A high grade and stage of tumors of the renal pelvis indicate a high possibility of tumor progression. Radical eradication of the lesion to decrease the chance of local recurrence is very important. Determining the disease-free 5- and 10-year survival rates in this series requires longer follow-up periods.