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目的:提高肾盂癌的治疗效果。方法:采取回顾性研究方法对47例肾盂癌预后因素进行分析。结果:肾盂癌3年生存率为65.9%(31/47),5年生存率为53.1%(24/47)。单纯肾盂癌5年生存率为55%(22/40),同时发生多器官癌5年生存率为26.7%(2/7),P>0.05。肿瘤直径>2.5cm者5年生存率为38.7%(12/31),低于肿瘤直径≤2.5cm者的75%(12/16),P<0.05。IVU重度肾盂肾盏积液或肾不显影者5年生存率为37.9%(11/29),低于无或轻度肾盂肾盏积液者的72.2%(13/18),P<0.05。细胞分级与生存率:5年生存率分别为G1100%(6/6),G265.2%(15/23),G316.7%(3/18),P<0.01。病理分期与生存率:5年生存率分别为T184.6%(11/13),T260.0%(12/20),T3～T47.1%(1/14),P<0.01。G2、T2肿瘤以上采取经腹根治性肾输尿管膀胱部分切除术5年生存率明显高于经腰部肾切除或肾输尿管切除及部分膀胱切除术者,P<0.05。术后再发与非再发膀胱癌者5年生存率无显著性差异,P>0.05。结论:肿瘤细胞分级、病理分期是决定预后的主要因素,采取根治性肾输尿管膀胱部分切除术是提高高分期分级肿瘤疗效的主要方法。
Objective: To improve the therapeutic effect of renal pelvis cancer. Methods: Retrospective study of 47 cases of renal pelvic cancer prognostic factors. Results: The 3-year survival rate of renal pelvic cancer was 65.9% (31/47) and the 5-year survival rate was 53.1% (24/47). The 5-year survival rate of simple renal pelvis cancer was 55% (22/40), while the multi-organ cancer 5-year survival rate was 26.7% (2/7), P> 0.05. The 5-year survival rate of tumors> 2.5cm in diameter was 38.7% (12/31), which was lower than 75% (12/16) of tumors <2.5cm in diameter, P <0.05. The 5-year survival rate was 37.9% (11/29) in IVU patients with severe pyelonephrosis or renal non-visualization, which was lower than 72.2% (13/18) in those without or with pyelonephrosis, P <0.05. The 5-year survival rates were G1100% (6/6), G265.2% (15/23) and G316.7% (3/18) respectively, P <0.01. The 5-year survival rates were T184.6% (11/13), T260.0% (12/20) and T3 ~ T47.1% (1/14) respectively, P <0.01. The 5-year survival rates of G2 and T2 tumors treated with radical nephroureterectomy were significantly higher than those with transurethral nephrectomy or partial nephroureterectomy (P <0.05). There was no significant difference in 5-year survival rate between recurrent and non-recurrent bladder cancer (P> 0.05). Conclusion: The classification of tumor cells and pathological staging are the main factors that determine the prognosis. The radical nephroureterectomy is the main method to improve the curative effect of high grade staging tumors.