Management of Bladder Cancer following Solid Organ Transplantation.
Management of Bladder Cancer following Solid Organ Transplantation.
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DOI：
10.1155/2011/256985
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发表时间：
2011
影响因子：
1.4
通讯作者：
Jackman SV
中科院分区：
文献类型：
--
作者：
Tomaszewski JJ;Larson JA;Smaldone MC;Hayn MH;Jackman SV
Objective.介绍我们处理肝肾移植后膀胱癌的经验。方法.对1992年1月至2007年12月间实体器官移植后诊断为膀胱尿路上皮癌（布克）的患者进行的单机构回顾性分析。结果在回顾的2,925例肾移植和2,761例肝移植受者中，我们确定了11例（0.2%）移植后诊断为布克。2例低度T1 TCC患者接受TURBT治疗。3例CIS患者和1例T1期低度布克癌患者接受TURBT和辅助BCG治疗。所有4例患者均存活，平均随访51 ± 22个月时无复发。1例T1高级别布克癌患者行根治性膀胱切除术，随访98个月仍无疾病。4例患者在移植后3.6年（中位数）被诊断为肌肉浸润性TCC。两名患者在根治性膀胱切除术后24个月和36个月无复发。1例无法切除的患者进行了尿流改道和姑息性XRT。结论.膀胱癌是罕见的肾和肝移植后，但它可以成功地管理与局部和/或切除治疗。在某些免疫抑制患者中，膀胱内接种卡介苗是可能的。
Objective. Present our experience managing bladder cancer following liver and renal transplantation. Methods. Single institution retrospective review of patients diagnosed with bladder urothelial carcinoma (BUC) following solid organ transplantation between January 1992 and December 2007. Results. Of the 2,925 renal and 2,761 liver transplant recipients reviewed, we identified eleven patients (0.2%) following transplant diagnosed with BUC. Two patients with low grade T1 TCC were managed by TURBT. Three patients with CIS and one patient with T1 low grade BUC were treated by TURBT and adjuvant BCG. All four are alive and free of recurrence at a mean follow-up of 51 ± 22 months. One patient with T1 high grade BUC underwent radical cystectomy and remains disease free with a follow-up of 98 months. Muscle invasive TCC was diagnosed in four patients at a median of 3.6 years following transplantation. Two patients are recurrence free at 24 and 36 months following radical cystectomy. Urinary diversion and palliative XRT were performed in one patient with un-resectable disease. Conclusions. Bladder cancer is uncommon following renal and liver transplantation, but it can be managed successfully with local and/or extirpative therapy. The use of intravesical BCG is possible in select immunosuppressed patients.
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