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背景与目的:脐尿管癌临床少见。本研究旨在探讨脐尿管癌的诊断与治疗方法,以提高其疗效。方法:回顾性分析中山大学肿瘤防治中心及中山大学附属第一医院1994年5月至2007年4月收治的14例脐尿管癌临床资料。结果:本组患者最常见的临床症状为血尿和膀胱刺激症状,膀胱镜检查主要表现为膀胱顶部宽基底肿物,影像学检查征象常见膀胱顶前壁与腹壁之间质软组织肿块影,常浸润膀胱壁。本组病例腺癌13例,恶性间质细胞瘤1例。7例行扩大性膀胱部分切除术患者中,1例术后24个月局部复发,6例随访14～120个月,中位随访42个月无复发;3例行全膀胱切除+尿流改道术,其中2例分别随访16个月和84个月无复发,1例术后3个月死于手术并发症;1例在外院行膀胱部分切除术,术后10个月局部复发;3例晚期未切除者行化疗,2例肿瘤无进展生存7个月和8个月,1例化疗后6个月死于肿瘤。本组病例1年、5年生存率分别为85.7%和61.2%。结论:扩大性膀胱部分切除术是值得推荐的手术方式。首次手术彻底切除肿瘤及对晚期及术后复发转移患者积极的综合治疗,是提高脐尿管癌疗效的关键。
Background and purpose: Ureteral cancer is rare. This study aimed to investigate the diagnosis and treatment of urachal carcinoma in order to improve its curative effect. Methods: The clinical data of 14 cases of urachal carcinoma admitted to Cancer Center of Sun Yat-sen University and the First Affiliated Hospital of Sun Yat-sen University from May 1994 to April 2007 were retrospectively analyzed. Results: The most common clinical symptoms of this group were hematuria and bladder irritation. Cystoscopy mainly showed wide basement of the bladder at the top of the bladder. Imaging findings showed common soft tissue mass between the anterior wall of the bladder and the abdominal wall, Bladder wall. This group of patients with adenocarcinoma in 13 cases, 1 case of malignant stromal tumor. Of the 7 patients who underwent extended partial cystectomy, 1 had a local recurrence 24 months after operation, 6 were followed up for 14 to 120 months, and there was no recurrence after a median follow-up of 42 months. Three patients underwent total cystectomy plus urinary diversion Two cases were followed up for 16 months and 84 months without recurrence. One case died of surgical complications at 3 months after operation. One case underwent partial cystal resection in the hospital and local recurrence occurred 10 months after operation. Three cases Chemotherapy was performed in patients with advanced unresectomy, progression-free survival in 2 patients for 7 months and 8 months, and 1 patient died of tumor 6 months after chemotherapy. The 1-year, 5-year survival rates were 85.7% and 61.2% respectively. Conclusion: Enlarged partial cystectomy is a recommended surgical procedure. The first surgery to completely remove the tumor and the patients with advanced and postoperative recurrence and metastasis of active comprehensive treatment is the key to improve the efficacy of urachal carcinoma.