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T1G3期膀胱肿瘤采用膀胱内卡介苗(丹麦1331株)治疗后的复发与进展

Recurrence and progression in stage T1G3 bladder tumour with intravesical bacille Calmette-Guérin (Danish 1331 strain).

作者信息

Kulkarni J N, Gupta R

机构信息

Department of Urology, Tata Memorial Hospital, Mumbai, India.

出版信息

BJU Int. 2002 Oct;90(6):554-7. doi: 10.1046/j.1464-410x.2002.02969.x.

Abstract

OBJECTIVE

To report recurrence and progression rates in patients with T1G3 superficial bladder carcinoma treated with intravesical bacille Calmette-Guérin (BCG, Danish 1331 strain) after complete transurethral resection.

PATIENTS AND METHODS

Data from the records of 111 patients with T1G3 bladder carcinoma treated between January 1991 and December 1999 were analysed for recurrence, progression, salvage therapy and survival.

RESULTS

Of the 111 patients with T1G3 bladder tumours, 69 had intravesical BCG therapy, 20 radical cystectomy and 22 only transurethral resection (TUR). Of the 69 patients receiving BCG therapy 37 (54%) had no recurrence, and 24 (35%) had a recurrence that was not muscle-invasive (Ta/T1) and were treated with TUR only. The remaining eight (12%) progressed to muscle invasion and had salvage cystectomy. During the follow-up six patients died, four from disease and three from other causes, while the remaining 63 are alive and well. Of the other 42 patients, 15 are alive after radical cystectomy and 18 after TUR.

CONCLUSION

This series further confirms the benefits of intravesical BCG (Danish 1331) in an adjuvant setting; furthermore, this treatment facilitates bladder preservation by reducing recurrences and delaying the progression in many patients.

摘要

目的

报告经尿道完全切除术后接受膀胱内卡介苗(BCG,丹麦1331株)治疗的T1G3浅表性膀胱癌患者的复发率和进展率。

患者与方法

分析1991年1月至1999年12月期间治疗的111例T1G3膀胱癌患者的记录数据,以了解复发、进展、挽救治疗和生存情况。

结果

111例T1G3膀胱肿瘤患者中,69例接受膀胱内卡介苗治疗,20例行根治性膀胱切除术,22例仅行经尿道切除术(TUR)。在接受卡介苗治疗的69例患者中,37例(54%)无复发,24例(35%)复发但未侵犯肌肉(Ta/T1),仅接受经尿道切除术治疗。其余8例(12%)进展为肌肉浸润并接受挽救性膀胱切除术。随访期间,6例患者死亡,4例死于疾病,3例死于其他原因,其余63例患者存活且情况良好。在其他42例患者中,15例在根治性膀胱切除术后存活,18例在经尿道切除术后存活。

结论

本系列研究进一步证实了膀胱内卡介苗(丹麦1331株)在辅助治疗中的益处;此外,这种治疗通过减少复发和延缓许多患者的病情进展,有助于保留膀胱。

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