臨床泌尿器科74巻5号

2020年04月発行

綜説

膀胱癌に対するリンパ節郭清

著者： 中川徹¹

所属機関： ¹帝京大学医学部泌尿器科学教室

ページ範囲：P.273 - P.281

文献概要

要旨

　骨盤リンパ節郭清は，膀胱癌に対する根治的膀胱全摘除術において必須である．リンパ節郭清によって得られた情報は予後予測・治療方針策定に有用であり（診断的意義），一部の症例では郭清による予後改善効果が示されている（治療的意義）．郭清範囲は，複数の後ろ向き研究の結果に基づき，大動脈分岐部以下あるいは尿管交差部以下の総腸骨・仙骨前・内腸骨・閉鎖・外腸骨リンパ節の郭清が推奨されている．しかし，最近報告された無作為化比較試験（RCT）の結果によると，総腸骨動脈分岐部以下の郭清と比較して，傍大動脈・傍下大静脈領域まで郭清範囲を拡大しても，予後は改善しなかった．今後のさらなる検証を待つ必要がある．

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