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目的:探讨泌尿系小细胞癌的诊治方法、疗效及预后。方法:回顾性分析我院2003年1月~2012年12月收治的11例泌尿系小细胞癌的病理、临床特征、诊断方法、治疗方法等资料,并对患者治疗效果、生存期等进行分析。结果:11例患者,男9例,女2例,平均年龄66.9(57~83)岁,肿瘤位于膀胱5例(1例为女性),右肾3例(1例为女性),左肾1例,前列腺2例。按TNM分期,膀胱肿瘤:T2b N0M01例,T2b N1M01例,2例均行根治性膀胱全切+肠代膀胱术,分别于术后24个月及13个月死亡;T2b N2M11例,T3b N2M11例,此2例行根治性膀胱全切+放疗+化疗,分别于术后9个月、12个月死亡;T4N2M11例,行放疗+化疗,3个月后死亡。肾脏肿瘤:T1a N0M01例,T1b N0M01例,T2b N1M01例,T3b N2M11例,均行根治性肾切除术+放疗+化疗,3例于术后6个月、13个月、24个月死亡,1例至今4年尚存活。前列腺肿瘤:T1c N0M1b1例,行前列腺电切+放疗+化疗;T3b N1M1c1例,行放疗+化疗,随访时分别死于术后25个月及15个月。11例患者生存期最短3个月,目前最长48个月,平均17.5个月;1年生存率63.6%(7/11),5年生存率目前为0。结论:泌尿系小细胞癌恶性度高,预后差,手术联合放化疗可能会延长患者生存期、改善其生活质量。
Objective: To investigate the diagnosis and treatment of urinary small cell carcinoma, efficacy and prognosis. Methods: The pathology, clinical features, diagnosis and treatment of 11 cases of small cell carcinoma of the urinary tract treated in our hospital from January 2003 to December 2012 were retrospectively analyzed. The therapeutic effect and survival period of the patients were analyzed . Results: The 11 patients included 9 males and 2 females, with an average age of 66.9 (57-83) years. The tumors were located in 5 cases of bladder (1 case of female), 3 cases of right kidney (1 case of female) For example, 2 cases of prostate. According to TNM staging, the bladder tumors were T2b N0M01 and T2b N1M01. Both of them underwent radical cystectomy and intestinal metaplasia and died at 24 months and 13 months respectively. There were 11 cases of T2b N2M and 11 cases of T3b N2M , 2 cases of radical cystectomy + radiotherapy + chemotherapy, respectively, at 9 months, 12 months after the death; T4N2M11 cases underwent radiotherapy and chemotherapy, died after 3 months. Kidney tumor: T1a N0M01 cases, T1b N0M01 cases, T2b N1M01 cases, T3b N2M11 cases, all underwent radical nephrectomy + radiotherapy + chemotherapy, 3 cases died 6 months, 13 months and 24 months after operation, 1 Four cases have survived so far. Prostate tumor: T1c N0M1b1 cases, prostatectomy + radiotherapy + chemotherapy; T3b N1M1c1 cases, radiotherapy and chemotherapy, were followed up 25 months and 15 months after surgery. The shortest survival period of 11 patients was 3 months and the longest was 48 months (average 17.5 months). The 1-year survival rate was 63.6% (7/11) and the 5-year survival rate was 0 at present. Conclusions: Small cell carcinoma of the urinary tract has high malignancy and poor prognosis. Operation combined with radiotherapy and chemotherapy may prolong survival and improve quality of life.