Management of low grade papillary bladder tumors
Management of low grade papillary bladder tumors
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DOI：
10.1016/j.juro.2007.05.148
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发表时间：
2007-10-01
影响因子：
6.6
通讯作者：
Reuter, Victor E.
中科院分区：
文献类型：
--
作者：
Herr, Harry W.;Donat, S. Machele;Reuter, Victor E.
目的：我们评估了低级别乳头状膀胱tumors.Materials和方法的管理和治疗结果：我们评估了215例诊断为低级别和非侵袭性乳头状膀胱肿瘤，并遵循他们每6个月与柔性膀胱镜为6至10年或更长时间。肿瘤复发采用经尿道电切术或门诊膀胱镜电灼治疗。结果：215例患者中有143例（67%）至少有1次复发（膀胱镜检查阳性）。中位随访时间为8年，肿瘤复发率平均为6.2（范围1 - 19），每年需要0.34次经尿道切除术或每3年1次经尿道切除术，或约每2年0.61次电灼或1次电灼。有17例（8%）患者的分级或分期发生进展，1例（0.5%）患者死于膀胱癌。最有可能复发的患者有多个肿瘤，低级别（TaLG）癌或肿瘤在第一次随访cystoscopy.Conclusions：监测膀胱镜检查在6个月的时间间隔加上门诊电灼治疗控制复发肿瘤，并降低诊断为低级别乳头状膀胱肿瘤的患者的治疗负担。
Purpose: We evaluated the management and treatment outcomes of low grade papillary bladder tumors.Materials and Methods: We evaluated 215 patients diagnosed with low grade and noninvasive papillary bladder tumors, and followed them every 6 months with flexible cystoscopy for 6 to 10 or more years. Tumor recurrence was treated with transurethral resection or outpatient cystoscopic fulguration.Results: Of the 215 patients 143 (67%) had at least 1 recurrence (positive cystoscopy). With a median followup of 8 years tumor recurrences averaged 6.2 (range 1 to 19) requiring 0.34 transurethral resections per year or 1 transurethral resection every 3 years, or 0.61 fulgurations or 1 fulguration approximately every 2 years. There were 17 patients (8%) who had progression in grade or stage and I patient (0.5%) died of bladder cancer. Patients most likely to have recurrence had multiple tumors, low grade (TaLG) carcinoma or tumor at first followup cystoscopy.Conclusions: Surveillance cystoscopy at 6-month intervals coupled with outpatient fulguration controls recurrent tumors and reduces the therapeutic burden for patients diagnosed with low grade papillary bladder tumors.