21例老年膀胱癌相关多原发癌临床分析
Clinical Analysis of 21 Cases of Multiple Primary Cancers Associated with Bladder Cancer in Elderly Patients
-
摘要:目的 研究分析老年膀胱癌相关多原发癌的临床特点。方法 对贵阳医学院附属医院1997年8月~2011年8月间收治的21例老年膀胱癌相关多原发癌患者临床资料进行回顾性分析。结果 21例患者均经病理证实为膀胱癌相关多原发癌, 占同期收治膀胱癌患者的1.48%(21/1 415), 总生存率为76.2%, 前7年确诊6例, 后7年确诊15例, 老年膀胱癌相关多原发癌另一癌发生在泌尿系统9例, 消化系统5例, 呼吸系统3例, 生殖系统2例, 其他(乳腺)2例。同时性老年膀胱癌相关多原发癌9例, 4例死亡, 5例随访3~48个月生存。异时性12例, 1例死亡, 11例在第一癌治疗后53~144个月生存。同、异时性老年膀胱癌相关多原发癌的累积生存率有明显统计学差异(P=0.004), 肿瘤分期与生存率密切相关(P < 0.001)。结论 老年膀胱癌相关多原发癌的发病率有增高趋势, 另一癌以泌尿系统、消化系统、呼吸系统多见, 异时性老年膀胱癌相关多原发癌的累积生存率高于同时性, 肿瘤分期越高预后越差, 早期诊断, 早治疗, 可以提高患者的生存期。Abstract:Objective To investigate the clinical features of multiple primary cancers(MPC) associated with bladder cancer in elderly patients.Methods The records of 21 elderly patients with MPC associated with bladder cancer treated in our hospital from August 1997 to August 2011 were reviewed.Results Out of 1, 415 bladder cancer patients treated contemporarily, 21(1.48%) were diagnosed with MPC associated with bladder cancer through biopsy.The overall survival rate of elderly patients with this condition was 76.2%.Six patients suffered from MPC associated with bladder cancer in the first seven years.Fifteen patients suffered from this disease in the next seven years. A total of 9 of the 21 elderly patients with MPC associated with bladder cancer suffered from other neoplasms involving the urinary system, including 5 in the digestive system, 3 in the respiratory system, 2 in the genital system, and 2 in other systems.In addition, 9 elderly patients were confirmed of having synchronous MPC associated with bladder cancer: 4 died, and 5 survived after 48 months follow-up.The other 12 patients suffered from metachronous MPC associated with bladder cancer: 1 elderly patient died, and the remaining 11 were followed up for 53 to 144 months after treatment for the first carcinoma.The cumulative survival rates of the elderly patients with synchronous and metachronous MPC associated with bladder cancer were significantly different.Therefore, the tumor staging of MPC associated with bladder cancer in elderly patients is closely associated with the survival rates.Conclusion The incidence of MPC associated with bladder cancer in elderly patients is increasing.The other neoplasms of this disease in elderly patients are frequently found in the urinary, digestive, and respiratory systems.The cumulative survival rate in elderly patients with metachronous MPC associated with bladder cancer is higher than that of the synchronous type.The high tumor staging of this disease in elderly patients is closely associated with the low survival rates.Early diagnosis and appropriate treatment of malignant neoplasms may be the only approach to achieving long-term survival.
下载: