男性原发尿道尿路上皮癌4例回顾分析

A retrospective study of male primary urethral urothelium carcinoma(a report of 4 cases)

目的探讨现阶段男性原发尿道尿路上皮癌的临床特点、治疗和预后。方法回顾了2005～2013年我院收治的4例男性原发尿道尿路上皮癌患者的临床资料。蛄果患者年龄50～73岁，2例有吸烟史，3例发生于后尿道，1例发生于尿道外口处。3例行经尿道电切术，1例开放手术切除尿道肿物，2例术后膀胱灌注羟基喜树碱治疗，1例使用多西他赛＋奥沙利铂辅助化疗。3例存活至今，其中2例T1期高级别患者分别在术后1月、3月复发，1例失访。结论男性原发尿道尿路上皮癌术前应常规检查核磁共振排除淋巴结转移，经尿道电切术＋膀胱灌注羟基喜树碱是后尿道表浅肿瘤一种很好的治疗方式，前尿道表浅肿瘤可行保留阴茎的肿物切除术，如无转移证据，不建议术中清扫淋巴结。

Objective To explore the clinical characteristics,treatment and prognosis of male primary urethral urothelium carcinoma （MPUUC）. Methods The clinical data of 4 cases of MPUUC treated during 2005 to 2013 were retrospectively analyzed. Results The patients aged 50 to 73 years, and Two of them had smoking history. Three cases had tumors located at posterior urethral,while the other at external urethral orifice. Three cases were treated by transurethral resection, while the other underwent open surgery. Two cases had hydroxycamptothecine intravesical infusion after surgery, and one received docetaxel combined oxaliplatin intravenous chemotherapy. Follow-up visits revealed 3 patients have lived to now but 2 recurred 1 month and 3 months after surgery. One case had loss to follow-up. Conclusions To MPUUC,we suggest MRI as a routine practice to exclude lymphatic metastasis. TUR combined with hydroxycamptothecine intravesical infusion is an appropriate treatment for posterior urethral superficial tumors. Patients with anterior urethral tumors can have tumor excised with pennis reserved. We deprecate lymph node dissection unless there is evidence of metastasis.