输尿管部分切除术治疗原发性输尿管癌的长期随访分析

Analysis of long-term follow-up results of segmental ureterectomy for primary transitional cell carcinoma of the ureter

目的：探讨保留肾脏的输尿管部分切除术治疗原发性输尿管癌的长期疗效。方法：回顾性分析1999年3月~2013年2月行保留肾脏的输尿管部分切除术的31例输尿管癌患者临床资料：12例患者行输尿管膀胱再植术,19例行输尿管端端吻合术。随访14~171个月,观察术后尿路肿瘤复发率、患者总体生存率、肿瘤分期及病理分级方面分层生存率等情况。结果：术后尿路肿瘤复发率为19.35%（6/31）;总体5年及10年生存率分别为77.41%、58.64%;低肿瘤分期组5年及10年生存率均为86.67%,高肿瘤分期组5年及10年生存率分别为74.93%和54.29%;低病理分级组5年及10年生存率均为76.00%,高病理分级组5年及10年生存率分别为78.26%和48.83%。结论：在严密随访下,输尿管部分切除术可以有效治疗低分期、低分级输尿管癌。

Objective：To evaluate the long-term oncological outcome in patients with primary transitional cell carcinoma of the ureter electively treated with segmental ureterectomy.Method：From March 1999 to February2013,31 cases of transitional cell carcinoma of the ureter were investigated retrospectively.The following surgeries were carried out：12ureterocystostomies with bladder cuff excision（38.71%）,19 segmental ureterectomies with end-to-end anastomoses（61.29%）.The follow-up period was 14-171 months.The recurrence of urothelial carcinoma,overall survival rate,and survival rate of stratified tumor stage and tumor grade were analyzed.Result：Recurrence of urothelial carcinoma was found in six patients（19.35%）.The 5-year overall survival was 77.41%and 10-year overall survival was 58.64%.The 5-year and 10-year survival in low tumor stage group were all86.67%,and were 74.93% and 54.29% respectively in high tumor stage group.The 5-year and 10-year survival in low tumor grade group were all 76.00%,and were 78.26% and 48.83% respectively in high tumor grade group.Conclusion：With strict follow-up visit,segmental ureterectomy is a feasible treatment option in patients with low stage and grade transitional cell carcinoma of the ureter.