泌尿系小细胞癌的诊断及治疗(附11例报告)

方克伟; 董彪; 何进; 邱学德; 李志鹏; 李泽惠

泌尿系小细胞癌的诊断及治疗(附11例报告)

- 昆明医科大学第二附属医院泌尿外科(昆明, 650101)

详细信息

通讯作者: 方克伟,E-mail:fkw_waley@126.com

中图分类号: R737

收稿日期: 2013-05-30

Diagnosis and treatment of small cell carcinoma of the urinary tract(Report of 11 cases)

- Second Hospital of Kunming Medical University, Kunming, Yunnan, 650101, China

More Information

Corresponding author: FANG Kewei, E-mail: fkw_waley@126.com

Received Date: 30 May 2013

摘要

摘要: 目的：探讨泌尿系小细胞癌的诊治方法、疗效及预后。方法：回顾性分析我院2003年1月~2012年12月收治的11例泌尿系小细胞癌的病理、临床特征、诊断方法、治疗方法等资料，并对患者治疗效果、生存期等进行分析。结果：11例患者，男9例，女2例，平均年龄66.9（57~83）岁，肿瘤位于膀胱5例（1例为女性），右肾3例（1例为女性），左肾1例，前列腺2例。按TNM分期，膀胱肿瘤：T_2bN₀M₀ 1例，T_2bN₁M₀ 1例，2例均行根治性膀胱全切+肠代膀胱术，分别于术后24个月及13个月死亡；T_2bN₂M₁ 1例，T_3bN₂M₁ 1例，此2例行根治性膀胱全切+放疗+化疗，分别于术后9个月、12个月死亡；T₄N₂M₁ 1例，行放疗+化疗，3个月后死亡。肾脏肿瘤：T_1aN₀M₀ 1例，T_1bN₀M₀ 1例，T_2bN₁M₀ 1例，T_3bN₂M₁ 1例，均行根治性肾切除术+放疗+化疗，3例于术后6个月、13个月、24个月死亡，1例至今4年尚存活。前列腺肿瘤：T_1cN₀M_1b 1例，行前列腺电切+放疗+化疗；T_3bN₁M_1c 1例，行放疗+化疗，随访时分别死于术后25个月及15个月。11例患者生存期最短3个月，目前最长48个月，平均17.5个月；1年生存率63.6%（7/11），5年生存率目前为0。结论：泌尿系小细胞癌恶性度高，预后差，手术联合放化疗可能会延长患者生存期、改善其生活质量。
- 膀胱 /
- 肾脏 /
- 前列腺 /
- 小细胞癌
Abstract: Objective: To investigate the diagnosis, treatment and prognosis of small cell carcinoma of urinary tract.Method: The pathological and clinical data of 11 cases of small cell carcinoma in urinary tract from Jan 2003 to Dec 2012 were analyzed retrospectively. Moreover, the therapeutic effect and survival time were investigated.Result: Eleven cases included nine males and two females with an average age of 66.9 years. The tumor of five cases were found in bladder (one female), three cases in right kidney (one female), one case in left kidney, two cases in prostate. According to TNM staging, tumor of bladder T_2bN₀M₀ was found in one case, T_2bN₁M₀ was found in one case, both were treated with radical cystectomy and neobladder construction. The above two patients died 24 months and 13 months respectively after the operation. Tumor of bladder T_2bN₂M₁ was shown in one case and T_3bN₂M₁ was seen in one case, who were treated with radical cystectomy combined with radiotherapy and chemotherapy. They died nine months and 12 months respectively after the operation. One case of bladder tumor T₄N₂M₁ received radiotherapy and chemotherapy who died three months later. Tumor of kidney T_1aN₀M₀ was seen in one case, T_1bN₀M₀ in one case and T_2bN₁M₀ in one case, T_3bN₂M₁ in one case as well. These four cases were treated with radical nephrectomy combined with radiotherapy and chemotherapy. Three of them died 6, 13, 24 months after the operation respectively. One of them has been alive for four years. Tumor of prostate T_1cN₀M_1b was observed in one case who was treated with transurethral resection of prostate plus radiotherapy and chemotherapy. The patient died 25 months later. Tumor of prostate T_3bN₁M_1c was found in one case who was treated with radiotherapy and chemotherapy. This case died 15 months later. The survival time of 11 cases was from three months to 48 months (average of 17.5 months). The survival rate was 63.6% (7/11) at one year and 0 at five years at present.Conclusion: The urinary small cell carcinoma is highly malignant with poor prognosis. Operation combined with radiotherapy and chemotherapy may prolong the patients' survival time and improve their quality of life.
- bladder /
- kidney /
- prostate /
- small cell carcinoma

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