浅表性膀胱癌的临床治疗

目的探讨浅表性膀胱癌的治疗方法.方法浅表性膀胱癌(Ta-1,G1-2)49例,平均年龄60岁,施行经尿道膀胱电切(TURBT)34例,部分膀胱切除15例.术后表阿霉素(EPI)加卡介苗(BCG)膀胱内灌注40例,丝裂霉素C膀胱灌注9例,定期膀胱镜检查,尿细胞学检查和随访.结果 49例患者经1～3次治疗,随访12～72个月,平均36个月.14例出现1次或1次以上的复发,最后9例进展为T2以上的分期肿瘤.6例施行膀胱全切,2例发生远处转移,3例死于膀胱肿瘤.结论浅表性膀胱癌患者早期行TURBT或膀胱部分切除,术后膀胱内药物灌注预防肿瘤复发,并严密随访,对肿瘤进展迅速者应尽快施行根治性膀胱全切术.

Clinical Treatment of Primary Superficial Bladder Cancer

Objective To explore the treatment for primary superficial bladder cancer. Methods 49 cases of (stages Ta-1,grades1-2)superficial bladder carcinoma with average age of 60 were recruited.34 Cases were received TURBT and 15 of which were given partial cystectomy.Postoperatively intravesical epirubicin (EPI) plus bacillus calmette-Guerin(BCG)were given to in 40 cases and mitomycin C insfillation was adminstrated for other 9 cases. Results Followup 12-72 months(median 36),14 cases had recurrence.9 cases had tumors progressed to muscle invasion (T2 or higher).6 cases had received total cystectomy and 2 cases had long-distance metastasis,and 3 cases died from tumors. Conclusion Patients who have superficial bladder carcinoma should be treated by TURBt and partial cystectomy and intravesical EPI plus BCG instillation and follow-up should be given.When The turmor recurs and progresses into muscle invasion,the total cystoctomy is highly preferred.