Analysis of factors predicting intravesical recurrence of superficial transitional cell carcinoma of the bladder without concomitant carcinoma in situ
Analysis of factors predicting intravesical recurrence of superficial transitional cell carcinoma of the bladder without concomitant carcinoma in situ
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DOI：
10.1111/j.1442-2042.2006.01562.x
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发表时间：
2006-11-01
影响因子：
2.6
通讯作者：
Fujisawa, Masato
中科院分区：
文献类型：
--
作者：
Sakai, Iori;Miyake, Hideaki;Fujisawa, Masato
背景资料：本研究的目的是探讨膀胱内复发的危险因素与浅表性膀胱癌患者没有伴随原位癌（CIS）：方法：在这一系列，我们分析了数据，从新诊断的浅表性Ta或T1移行细胞癌（TCC）的膀胱没有伴随CIS谁接受了完全经尿道切除术（TUR），没有任何辅助膀胱灌注治疗。采用多因素分析确定影响TUR术后膀胱内复发的重要危险因素。原发性和复发性肿瘤的临床病理特征之间的差异也characterized.Results：在341例接受TUR的Ta或T1膀胱癌，187诊断为伴随CIS和/或治疗与辅助膀胱内治疗被排除在外，其余154进行了评价。154例患者中有64例膀胱内复发，5年无复发生存率为58.3%。在检查的几个因素中，只有肿瘤大小与膀胱内复发显著相关。多变量分析确定肿瘤大小是膀胱内复发的独立预测因子，而与其他参数无关，包括年龄、性别、多样性、生长模式、分级和分期。复发性肿瘤明显小于原发性肿瘤，级别和分期较低，尽管它们之间的生长模式和多样性没有差异。结论：这些发现提示原发肿瘤大小可作为预测浅表膀胱移行细胞癌TUR术后膀胱内复发的潜在危险因素，复发性肿瘤的病理特征比原发性肿瘤的病理特征更有利。
Background: The objective of this study was to investigate risk factors for intravesical recurrence in patients with superficial bladder cancer without concomitant carcinoma in situ (CIS).Methods: In this series, we analyzed data from patients with newly diagnosed superficial Ta or T1 transitional cell carcinoma (TCC) of the bladder without concomitant CIS who underwent complete transurethral resection (TUR) without any adjuvant intravesical instillation therapies. Multivariate analysis was used to determine significant risk factors affecting intravesical recurrence after TUR. Differences in clinicopathological features between primary and recurrent tumors were also characterized.Results: Among 341 patients undergoing TUR of Ta or T1 bladder cancer, 187 diagnosed as having concomitant CIS and/or treated with adjuvant intravesical therapy were excluded, and the remaining 154 were evaluated. Intravesical recurrence was detected in 64 of the 154 patients, showing a 5-year recurrence-free survival rate of 58.3%. Among several factors examined, only tumor size was significantly associated with intravesical recurrence. Multivariate analysis identified tumor size as an independent predictor for intravesical recurrence irrespective of other parameters including age, gender, multiplicity, growth pattern, grade and stage. Recurrent tumors were significantly smaller and of a lower grade and lower stage than primary tumors, despite the absence of differences in growth pattern and the multiplicity between them.Conclusions: These findings suggest that primary tumor size could be used as a potential risk factor for predicting intravesical recurrence following TUR of superficial TCC of the bladder without concomitant CIS, and that the pathological characteristics of recurrent tumors are more favorable than those of primary tumors.