CONTEMPORARY CYSTECTOMY WITH PELVIC NODE DISSECTION COMPARED TO PREOPERATIVE RADIATION-THERAPY PLUS CYSTECTOMY IN MANAGEMENT OF INVASIVE BLADDER-CANCER
CONTEMPORARY CYSTECTOMY WITH PELVIC NODE DISSECTION COMPARED TO PREOPERATIVE RADIATION-THERAPY PLUS CYSTECTOMY IN MANAGEMENT OF INVASIVE BLADDER-CANCER
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DOI：
10.1016/s0022-5347(17)50809-5
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发表时间：
1984-01-01
影响因子：
6.6
通讯作者：
LIESKOVSKY, G
中科院分区：
文献类型：
--
作者：
SKINNER, DG;LIESKOVSKY, G
1971年8月至1982年8月，对197例高级别浸润性膀胱癌患者进行了单期根治性膀胱切除联合盆腔淋巴结清扫及尿流改道治疗。100例术前放疗1600rad，连续4d，97例行手术治疗。虽然不构成前瞻性随机研究，但由同一手术团队在11年内使用相同的手术技术对这两组患者进行的分析提供了有用的信息，质疑了术前放射治疗在高级别浸润性膀胱癌治疗中的益处。其他因素，如改进的手术技术和细致的盆腔淋巴结清扫，以及更好的术前和术后护理，可能是当代手术的存活率仅与采用术前放射治疗的综合治疗方案报道的结果相当的原因。同期手术加或不加术前放射治疗，病理分期P2和P3A疾病患者的5年无瘤生存率为75%，P3A和P3B疾病患者为44%，P4减少和阳性盆腔结节患者为36%。
Between Aug. 1971 and Aug. 1982, 197 consecutive patients underwent single stage radical cystectomy with pelvic lymph node dissection and urinary diversion as definitive management of high grade, invasive bladder cancer. In 100 patients 1600 rad of radiation therapy were given for 4 days preoperatively and 97 patients underwent an operation only. Although not constituting a prospective randomized study, an analysis of these 2 groups of patients managed during an 11-yr period by the same surgical team, using identical surgical technique, provides useful information that questions the benefit of preoperative radiation therapy in the management of high grade, invasive bladder cancer. Other factors, such as improved surgical technique with meticulous pelvic node dissection as well as better preoperative and postoperative care, may be responsible for survival results of contemporary surgery that equal only those reported following combination therapy protocols using preoperative radiation therapy. Contemporary surgery with or without preoperative radiation therapy yielded a 5-yr survival rate free of tumor of 75% for patients with pathologic stages P2 and P3A disease, 44% with P3A and P3B disease, and 36% with P4 decrease and positive pelvic nodes.