Risk Factors for Intravesical Recurrence in Patients with High-grade T1 Bladder Cancer in the Second TUR Era
Risk Factors for Intravesical Recurrence in Patients with High-grade T1 Bladder Cancer in the Second TUR Era
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DOI：
10.1093/jjco/hyt016
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发表时间：
2013-04-01
影响因子：
2.4
通讯作者：
Nishiyama, Hiroyuki
中科院分区：
文献类型：
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作者：
Takaoka, Ei-ichiro;Matsui, Yoshiyuki;Nishiyama, Hiroyuki
我们的目的是阐明高级别T1膀胱癌在第二次经尿道切除术后膀胱内复发的危险因素，分析包括73例初次经尿道切除的高级别T1膀胱癌患者。中位随访期为49.2个月。统计分析无复发生存率、无进展生存率及与肿瘤残留或无复发生存率相关的危险因素，第二次经尿道电切病理结果分别为pT 0 36（49）、pTis/a 21（29）、pT 1 13（18）和pT 2 3（4）。第二次经尿道切除术时残留肿瘤的风险因素是初次经尿道切除术时存在伴随原位癌（P 0.01）。所有57例pT 0/is/a肿瘤患者在第二次经尿道切除术中保留了膀胱，43例（75例）接受膀胱内BCG治疗。在这些患者中，3年无复发生存率和3年无进展生存率分别为81和96。此外，第二次经尿道切除术时存在pTis/a残留肿瘤对复发有显著影响。第二次经尿道电切术pT 1的13例患者中有5例立即接受根治性化疗或放疗联合化疗，8例接受BCG膀胱灌注治疗的患者中有2例（25）出现了包括远处转移在内的进展。第二次经尿道电切术。在该组中，第二次经尿道切除术时残留的肿瘤是膀胱内复发的危险因素。
We aimed to elucidate risk factors for intravesical recurrence of high-grade T1 bladder cancer in the second transurethral resection era.The analysis included 73 patients with high-grade T1 bladder cancer on initial transurethral resection. The median follow-up period was 49.2 months. Recurrence-free survival, progression-free survival and risk factors related to the presence of residual tumors or recurrence-free survival were statistically analyzed.The pathological findings for second transurethral resection were pT0 36 (49), pTis/a 21 (29), pT1 13 (18) and pT2 3 (4), respectively. The risk factor for residual tumors at second transurethral resection was the presence of concomitant carcinoma in situ at the initial transurethral resection (P 0.01). The bladder was preserved in all 57 patients with pT0/is/a tumors on second transurethral resection, and 43 patients (75) received intravesical BCG therapy. Of these patients, 3-year recurrence-free survival and 3-year progression-free survival rates were 81 and 96, respectively. In addition, the presence of pTis/a residual tumors on second transurethral resection had a significant impact on the recurrence. Five of the 13 patients with pT1 on second transurethral resection were immediately treated by radical cystectomy or radiation therapy combined with chemotherapy, and two (25) of the eight who were treated by intravesical BCG therapy had progression including distant metastasis.High recurrence-free survival and progression-free survival were achieved by a second transurethral resection and intravesical BCG therapy in the patients with pT0/is/a on the second transurethral resection. In this group, the residual tumors at second transurethral resection are risk factors for intravesical recurrence.