膀胱部分切除术加膀胱灌注化疗治疗膀胱肿瘤

Partial Cystectomy Plus Chemotherapy via Irrigation of Bladder for Treatment of Bladder Tumors

目的 :通过对膀胱部分切除术加膀胱灌注化疗治疗膀胱肿瘤 10 1例临床分析 ,了解该治疗方式的疗效。方法 :膀胱部分切除术加术后膀胱内灌注化疗 ,化疗药主要是 MMC、5 - FU、表阿霉素。结果 :术后 1年内复发率 18.81% ,3年内复发率 42 .5 7% ,5年内复发率 45 .5 4% ,术后 1年内病死率为 2 .97% ,3年内病死率为 8.91% ,5年内病死率为2 1.78% ,5例死于心血管疾病 ,2例死于脑栓塞 ,15例死于癌肿复发并远处转移 ,5年生存率为 78.2 2 %。结论 :膀胱部分切除术能有效保留膀胱 ,使其维持自身生理功能 ,提高患者生活质量 ,术后膀胱灌注化疗可在提高生存率同时有效降低术后复发率。

Objective:To investigate the therapeutic outcomes from partial cystectomy followed by chemotherapy through irrigation of bladder for treatment of bladder tumors.Methods:Partial cystectomy was performed in 101 patients with bladder tumors,which was postoperatively followed by chemotherapy with MMC,5 Fu or E ADM delivered by irrigation of bladder.A follow up observation for tumor recurrence and mortality was carried out.Results:The recurrence rates in one,three and five years were 18.81%,42.5% and 45.54%,respectively;and the mortality rates in the same periods were 2.97%,8.91% and 21.78%(22/101),respectively,with a survival rate of 78.22% in five years.Of the 22 patients died in five years,five were died of cardiavescular disease,two died of cerebral embolish and 15 died of reeurrence with remote metastasis of the tumor.Conclusions:The results indicate that since partial cystectormy allows patient to functionally retain his bladder,which can improve life quality,chemotherapy following the surgical operation via irrigation can reduce recurrence of the tumor and the mortality,therefore improve suvrvival rate.