肌层浸润性膀胱癌保留膀胱手术的临床观察

目的　探讨肌层浸润性膀胱尿路上皮癌保留膀胱手术的有效性及安全性。方法　收集２００３年６月至２００７年６月行保留膀胱手术的４１例肌层浸润性膀胱癌患者的临床资料，其中行膀胱部分切除术（ＰＣ）２９例，行根治性经尿道膀胱肿瘤电切术（ＴＵＲＢＴ）１２例。采用吡柔比星３０ｍｇ／次膀胱灌注化疗，每周１次，共８次，继而每月１次，共持续１年。每３个月行膀胱镜检查１次，持续２年。结果　ＰＣ组术后１、３年无瘤生存率分别为８２８％（２４／２９）和５５.２％（１６／２９），ＴＵＲＢＴ组分别为７５％（９／１２）和５０％（６／１２），两组差异均无统计学意义（Ｐ＞０.０５）。ＰＣ组术后肿瘤复发率为３４.５％（１０／２９），首次肿瘤中位复发时间为９.５个月；ＴＵＲＢＴ组术后肿瘤复发率为４１.７％（５／１２），首次肿瘤中位复发时间为８.０个月，两组差异均无统计学意义（Ｐ＞０.０５）。结论　对于身体条件不能耐受或不愿接受根治性膀胱全切术的肌层浸润性膀胱癌患者，行保留膀胱手术联合术后化疗是一种可行的治疗方案。

Clinical study of bladder preservation strategy of muscle-invasive bladder cancer

Objective To study the clinical efficacy and sefety of bladder preservation strategy of muscle-invasive bladder cancer.Methods Forty-one patients with muscle-invasive bladder cancer were enrolled from June 2003 to June 2007.Twenty-nine patients underwent partial cystectomy(PC),while the remaining 12 patients underwent radical transurethral resection of bladder tumor(TURBT).Pirarubicin 30mg each time was applied as irrigation of bladder(once a week for 8 weeks and then once a month for 10 months).All patient...