膀胱腺癌(附27例报告)

目的　提高膀胱腺癌的诊治效果。方法　12 例脐尿管腺癌中,7 例行扩大性膀胱部分切除;15 例原发膀胱腺癌中,11 例行膀胱部分切除术。结果　膀胱腺癌总的5 年生存率25 .9 % 。脐尿管腺癌中,7 例行扩大性膀胱部分切除者,无一例局部复发,12 例中有4 例生存5 年。原发膀胱腺癌的治疗主要为膀胱部分切除术,生存5 年者3 例,局部复发4 例,均在原肿瘤部位。1 例原发膀胱腺癌皮下和腹股沟淋巴结转移患者和2 例脐尿管腺癌肺转移患者经化疗 放疗后分别生存24 ,28 和60个月。结论　脐尿管腺癌宜采用扩大性膀胱部分切除术,原发膀胱腺癌宜采用根治性膀胱全切除术。对复发转移患者应积极采取综合治疗,以提高生存率。

Adenocarcinoma of the urinary bladder :a report of 27 cases

Objective To analyze the therapeutic results of urinary bladder adenocarcinoma .Methods Twenty seven urinary bladder adenocarcinoma patients were treated from 1970 through 1997 .There were 12 cases of urachal adenocarcinoma and 15 cases of bladder adenocarcinoma . Hematuria with or without urinary tract irritation symptoms was the most com mon clinical manifestation .Results The overall 5 year survival rate was 25 .9 % .Among patients with urachal adenocarcinoma , 7 received extended partial bladder resection . None of them had local recurrence . Patients with bladder adenocarcinoma mainly received partial bladder resection , with which 4 developed local recurrence at the primary site . The 5 year survival rate of urachal adenocarcinoma and bladder adenocarcinoma was 33 .3 % and 20 .0 % ,respectively . One patient of bladder adenocarcinoma with skin andinguinal lymph node metastases and 2 patients of urachal adenocarcinoma with lung metastasis treated with chemotherapy and radiotherapy survived 24 , 28 and 60 months, respectively .Conclusion Extended partial bladder resection is the treatment of choice for urachal adenocarcinoma while radical cystectony for bladder adenocarcinoma . Comprehesive therapy should be given to patients with metastatic orrecurrent disease to improve survival.