Effect of routine repeat transurethral resection for superficial bladder cancer:: A long-term observational study
Effect of routine repeat transurethral resection for superficial bladder cancer:: A long-term observational study
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DOI：
10.1097/01.ju.0000070437.14275.e0
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发表时间：
2003-08-01
影响因子：
6.6
通讯作者：
Vögeli, TA
中科院分区：
文献类型：
--
作者：
Grimm, MO;Steinhoff, C;Vögeli, TA
目的：我们确定浅表性膀胱癌（Ta和T1）接受第二次经尿道膀胱肿瘤切除术（ReTURB）的患者复发和进展的长期结果。材料和方法：我们在1993年11月至1995年10月期间在德国一所大学医院进行了一项初始队列研究，124例连续的浅表性膀胱癌患者接受经尿道切除术和常规回肠手术（83例）。经尿道切除术后，所有病变立即记录在设计的膀胱图上。最初切除的疤痕和其他可疑病变平均在7周后恢复。随访患者至复发或死亡，或至少5年。结果：33%的ReTURB病例发现肿瘤残留，其中Ta占27%，T1占53%，在最初切除部位发现肿瘤残留的比例为81%。83例患者中有5例因ReTURB结果行根治性膀胱切除术。1 - 3年后的估计复发风险分别为18%，29%和32%。5年后，63%接受ReTURB治疗的患者仍然无病（平均无复发生存期62个月，中位87个月）。平均观察61个月后，仅有2例（3%）患者进展为肌肉侵袭性疾病。结论：这些数据表明浅表性膀胱癌患者行ReTURB术后复发和进展良好。至少在那些有膀胱保留意图的高危患者中，建议行膀胱切除术。
Purpose: We determined the long-term outcome in patients with superficial bladder cancer (Ta and T1) undergoing routine second transurethral bladder tumor resection (ReTURB) in regard to recurrence and progression.Materials and Methods: We performed an inception cohort study of 124 consecutive patients with superficial bladder cancer undergoing transurethral resection and routine ReTURB (83) between November 1993 and October 1995 at a German university hospital. Immediately after transurethral resection all lesions were documented on a designed bladder map. ReTURB of the scar from initial resection and other suspicious lesions was performed at a mean of 7 weeks. Patients were followed until recurrence or death, or a minimum of 5 years.Results: Residual tumor was found in 33% of all ReTURB cases, including 27% of Ta and 53% of T1 disease, and in 81% at the initial resection site. Five of the 83 patients underwent radical cystectomy due to ReTURB findings. The estimated risk of recurrence after years 1 to 3 was 18%, 29% and 32%, respectively. After 5 years 63% of the patients undergoing ReTURB were still disease-free (mean recurrence-free survival 62 months, median 87). Progression to muscle invasive disease was observed in only 2 patients (3%) after a mean observation of 61 months.Conclusions: These data suggest a favorable outcome regarding recurrence and progression in patients with superficial bladder cancer who undergo ReTURB. ReTURB is suggested at least in those at high risk when bladder preservation is intended.