肾盂输尿管癌术后再发尿路上皮癌

Postoperative recurrence of renal pelvic and ureteral cancer

１９７８年１月～１９９２年１２月收治肾盂输尿管癌８５例，术后再发尿路上皮癌２６例。肾输尿管膀胱袖状切除术后再发率（３０．１％）低于肾输尿管全切除术（５４．５％）和肾切除术（７５％）。病侧管口处膀胱癌再发率高。同时发生多部位癌、低级低期者术后再发率高，再发时间多在术后３年以内。术后再发与非再发者５年生存率无显著性差异（Ｐ＞０．０１）。对其再发因素早期发现与预后进行讨论。

cases of renal pelvic and ureteral cancer were admitted and treated from Jan. 1978 to Dec. 1992. Among them, recurrence of urinary tract epithelial cancer occurred in 26.The postoperative recurrence rate with renoureteral recection and sleeve shape resection of vesical (30.1%) was lower than that of total renoureteral resection (54.5%) and renal resection alone (75.0%).In the latter 2 groups, the occurrence of vesical cancer at the involved-side was higher. In cases of simultaneous multiple cancer, lower grade and lower stage cancers the recurrence rate was higher and usually occurred within 3 years. There was no difference of 5 year survival ratet (P<0.05) between recurrent and non-recurrent cases. The cause and prevention of recurrence and its early detection were discussed.