资源描述：
《膀胱癌淋巴清扫基础医学医药卫生专业资料课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、TheRoleofLymphadenectomyinBladderCancerJohnP.Stein,M.D.UniversityofSouthernCaliforniaKeckSchoolofMedicine,NorrisComprehensiveCancerCenter,LosAngelesCAHIGH-GRADE,INVASIVEBLADDERCANCERReality“Invasivebladdercancerisalethaldisease.”USCBLADDERCANCEREXPERIENCERationaleforCystectomyBest
2、survivalresultsLowestlocalrecurrenceratesImprovedmorbidityandmortalityUrinaryreconstructionhasimprovedqualityoflife(continentandorthotopicdiversion)EquallyeffectiveformsoftherapyhavenotemergedUSC/NORRISBLADDERCANCEREXPERIENCERecurrence-FreeSurvivalof1054Patients StratifiedbyLymphN
3、odeStatus(LN+vs.LN-)(6/71-12/97)051015YearsfromCystectomy0.000.100.200.300.400.500.600.700.800.901.00ProbabilityofNotRecurringLN+(n=244)LN-(n=810)P<0.001IncidenceofLymphNodeMetastasesatCystectomyAuthorYearsTotal#PtsLN+Poulsen‘90-’9719150(26%)Vieweg‘80-’90686193(28%)Leissner‘99-’02
4、29081(28%)Stein‘71-’971054246(24%)Totals2221570(25%)RiskFactorsforLymphNodeMetastasesFollowingRadicalCystectomy:TheConceptofLymphNodeDensityJohnP.Stein,M.D.UniversityofSouthernCaliforniaKeckSchoolofMedicine,NorrisComprehensiveCancerCenter,LosAngelesCAUSCRadicalCystectomyExperience
5、:Long-TermResultsin1,054PatientsJ.Clin.Oncol.,19:666,2001.RadicalcystectomywithBPLND24%ofpatientsLN+diseaseRiskfactorsinclude:p-stage#ofLNinvolvedOrganConfined(n=594)Extravesical(n=214)LymphNode(+)(n=246)P<0.001ProbabilityofNotRecurringUSCRadicalCystectomyExperience:Long-TermResul
6、tsin1,054PatientsJ.Clin.Oncol.,19:666,2001.RadicalcystectomywithBPLND24%ofpatientsLN+diseaseRiskfactorsinclude:p-stage#ofLNinvolvedUSCRadicalCystectomyExperience:Long-TermResultsin1,054PatientsJ.Clin.Oncol.,19:666,2001.RadicalcystectomywithBPLND24%ofpatientsLN+diseaseRiskfactorsin
7、clude:p-stage#ofLNinvolvedUSCRadicalCystectomyExperience:Long-TermResultsin1,054PatientsJ.Clin.Oncol.,19:666,2001.RadicalcystectomywithBPLND24%ofpatientsLN+diseaseRiskfactorsinclude:p-stage#ofLNinvolvedRadicalCystectomyExtentofLymphadenectomyPrognosticfactorsinLN-disease:Herretal,
8、JUrol,1671298,2002Poulsenetal,JUr
