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作者自1970年至1976年对202例原发性膀胱癌患者行根治性膀胱切除、双侧淋巴清扫、尿液转流手术。术后1个月内死亡率为24%。术后肿瘤病理分期及淋巴结转移:pT 1期(粘膜下)25例(12%),均无淋巴结转移;pT 2期(浅肌层)45例(22%),淋巴结转移达6%;pT 3期(深肌层)86例(43%),淋巴结转移达30%;pT 4期(膀胱外)46例(23%),淋巴结转移达58.6%。pT 1、pT 2、pT 3、pT 4肿瘤患者术后5年存活率分别为76%,56%,19%,0%。作者指出各年龄组患者的总存活率无明显差别,性别因素似乎对总存活率也不重要。只有肿瘤的分期(浸润程度)和分级能够影响根治性膀胱切除术患者的总存活率,因此是重要的预后因素。肿瘤深部浸润(T 3和T 4)的患者进一步按照N和M分期,存活率未见明显差异。在T3期肿瘤患者中,有与无淋巴结转移的存活率并无统计学的显著差异。因此,作者认
The authors performed radical cystectomy, bilateral lymphadenectomy, and urine bypass surgery on 202 patients with primary bladder cancer from 1970 to 1976. The mortality rate within 24 months after surgery was 24%. Postoperative pathological stage and lymph node metastasis: pT 1 stage (submucosa) in 25 cases (12%), no lymph node metastasis; pT stage 2 (superficial muscularis layer) in 45 cases (22%), lymph node metastasis was 6%; pT There were 86 cases (43%) in stage 3 (deep muscular layer), 30% lymph node metastasis, 46 cases (23%) in pT stage 4 (outside of the bladder), and 58.6% lymph node metastasis. The five-year survival rates of patients with pT 1, pT 2, pT 3, and pT 4 tumors were 76%, 56%, 19%, and 0%, respectively. The authors point out that there is no significant difference in overall survival among patients of all age groups, and gender factors do not appear to be important for overall survival. Only the stage (degree of invasion) and grade of the tumor can affect the overall survival rate of patients undergoing radical cystectomy and is therefore an important prognostic factor. Patients with deep tumor infiltration (T 3 and T 4) were further classified according to N and M stages, and there was no significant difference in survival rate. There was no statistically significant difference in the survival rate with lymph node metastasis in T3 stage tumor patients. Therefore, the author recognizes