CAJ | 학술논문

目的：探讨上尿路尿路上皮癌（ UUT-UC）患者行根治性肾输尿管切除术（ RNU）后膀胱肿瘤复发的危险因素。方法对209例行RNU的UUT-UC患者进行术后随访，记录膀胱肿瘤复发情况。分析UUT-UC的临床病理特征与术后膀胱肿瘤复发的关系，用Log-rank检验比较生存曲线。结果209例患者中，术后膀胱肿瘤复发59例（28．2％）。肿瘤多发者的膀胱肿瘤复发率为46．0％，明显高于单发者的22．0％（P＜0．01）；术前行输尿管镜检者的膀胱肿瘤复发率为46．7％，明显高于未行输尿管镜检者的31．5％（P＜0．01）。结论 UUT-UC患者的肿瘤病灶数以及术前是否行输尿管镜检术可作为判断患者根治性肾输尿管切除术后膀胱肿瘤复发的危险因素。
목적：탐토상뇨로뇨로상피암（ UUT-UC）환자행근치성신수뇨관절제술（ RNU）후방광종류복발적위험인소。방법대209례행RNU적UUT-UC환자진행술후수방，기록방광종류복발정황。분석UUT-UC적림상병리특정여술후방광종류복발적관계，용Log-rank검험비교생존곡선。결과209례환자중，술후방광종류복발59례（28．2％）。종류다발자적방광종류복발솔위46．0％，명현고우단발자적22．0％（P＜0．01）；술전행수뇨관경검자적방광종류복발솔위46．7％，명현고우미행수뇨관경검자적31．5％（P＜0．01）。결론 UUT-UC환자적종류병조수이급술전시부행수뇨관경검술가작위판단환자근치성신수뇨관절제술후방광종류복발적위험인소。
Objective To investigate the clinicopathological risk factors for intravesical recurrence ( IVR) in patients undergoing radical nephroureterectomy (RNU) for upper urinary tract urothelial carcinoma (UUT-UC).Methods The postoperative follow-up was conducted in 209 patients who underwent RNU for UUT-UC, and the case of IVR was recorded . We analyzed the relationships between the clinical and pathological features of UUT -UC with IVR.The Log-rank test was used to calculate survival functions .Results Of 209 patients, 59 cases (28.2%) developed IVR after RNU.The IVR rate of multifocal tumors was 46.0%, which was significantly higher than that of the single tumor (22.0%) (P<0.01). The IVR rate in patients who underwent preoperative ureteroscopy was 46.7%, which was significantly higher than those who did not undergo ureteroscopy (31.5%) (P<0.01).Conclusions Tumor multifocality and diagnostic ureteroscopy are the risk factors in developing IVR after RNU for UUT-UC.