5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer
5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer
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DOI：
10.1111/j.1464-410x.2004.05715.x
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发表时间：
2005-10-01
影响因子：
4.5
通讯作者：
Dvorácek, J
中科院分区：
文献类型：
--
作者：
Babjuk, M;Soukup, V;Dvorácek, J
目的探讨5-氨基乙酰丙酸诱导荧光膀胱镜(FC)在TUR治疗中对Ta/T1期膀胱移行细胞癌(TCC)复发率和无瘤间隔时间的影响。A组采用标准白光鼻内窥镜进行TUR，B组采用FC。采用标准膀胱镜和尿细胞学对患者进行随访。结果A组首次膀胱镜检查(TUR后10~15周)肿瘤复发23例(37%)，B组60例(8%)，A组12个月和24个月无复发生存率分别为39%和28%，B组分别为66%和40%(P=0.008，log-ranking检验)。在单独的分析中，在多发性肿瘤(P=0.001)和复发性肿瘤(P=0.02)中，使用FC的无复发存活率显著更高。在单发和原发肿瘤中，B组的中位复发时间也较长，但差异无统计学意义。结论TUR期间5-氨基乙酰丙酸诱导的FC降低了Ta/T1期膀胱TCC的复发率。最显著的好处是多发性和复发性肿瘤的患者。
OBJECTIVETo assess the influence of 5-aminolaevulinic acid-induced fluorescence cystoscopy (FC) during transurethral resection (TUR) on the recurrence rate and the length of tumour-free interval in stage Ta/T1 transitional cell carcinoma (TCC) of the urinary bladder.PATIENTS AND METHODSIn all, 122 patients with primary or recurrent stage Ta/T1 bladder TCC treated with TUR were enrolled in a prospective randomized study. In group A the TUR was performed with standard white-light endoscopy, and in group B with FC. The patients were followed using standard cystoscopyand urinary cytology. The recurrence-free interval was evaluated in whole groups, for single and multiple, and for primary and recurrent tumours separately.RESULTSAt the time of the first cystoscopy (10-15 weeks after TUR) tumour recurrence was detected in 23 of 62 patients (37%) in group A, but only in five of 60 patients (8%) in group B. The recurrence-free survival rates in group A were 39% and 28% after 12 and 24 months, compared to 66% and 40% respectively in group B (P=0.008, log-rank test). In separate analyses, the recurrence-free survival rates were significantly higher using FC in multiple (P= 0.001) and in recurrent (P= 0.02) tumours. In solitary and primary tumours the median time to recurrence was also longer in group B, but the difference was not statistically significant.CONCLUSION5-aminolaevulinic acid-induced FC during TUR reduces the recurrence rate in stage Ta/T1 bladder TCC. The most significant benefit is in patients with multiple and recurrent tumours.