Solsona E, Iborra I, Ricós J V, Monrós J L, Dumont R
Department of Urology, Instituto Valenciano de Oncologia, Spain.
J Urol. 1992 Jun;147(6):1513-5. doi: 10.1016/s0022-5347(17)37612-7.
A prospective study was done to evaluate treatment of patients with muscle-infiltrating bladder cancer by transurethral resection exclusively. Inclusion criteria for this study were histological confirmation of muscular bladder infiltration, endoscopic radical transurethral resection, disappearance of hardened areas after transurethral resection, and negative biopsies of the depth and periphery of the tumor bed. The study began in April 1981. The average followup in series 1 (April 1981 to December 1986, 59 patients) was 55.4 months. Actually, of the patients 31 (52.5%) are without evidence of recurrence and 28 (47.5%) have recurrent disease. Of the latter patients 11 (18.6%) had invasive bladder recurrence, including 7 (11.9%) who had recurrence at 3 months, which indicated clinical understaging. Three patients (5%) had metastases without bladder tumor. The remaining 14 patients (23.7%) had superficial bladder recurrence. The overall survival rate was 83% (49 of 59 patients) and 43 patients (72.8%) still retain the bladder. The present data are confirmed by the results of series 2 (December 1986 to August 1989). Therefore, the data would justify conservative management in a selected group of patients with muscle-infiltrating bladder cancer.
开展了一项前瞻性研究，专门评估经尿道切除术对肌肉浸润性膀胱癌患者的治疗效果。本研究的纳入标准为：组织学证实存在肌肉膀胱浸润、经尿道根治性切除术、经尿道切除术后硬化区域消失，以及肿瘤床深度和周边活检结果为阴性。该研究始于1981年4月。第1组（1981年4月至1986年12月，59例患者）的平均随访时间为55.4个月。实际上，31例（52.5%）患者无复发迹象，28例（47.5%）患者出现复发性疾病。在后者中，11例（18.6%）出现浸润性膀胱复发，其中7例（11.9%）在3个月时复发，这表明临床分期不足。3例（5%）患者无膀胱肿瘤转移。其余14例（23.7%）出现浅表性膀胱复发。总生存率为83%（59例患者中的49例），43例（72.8%）患者仍保留膀胱。第2组（1986年12月至1989年8月）的结果证实了目前的数据。因此，这些数据证明对选定的肌肉浸润性膀胱癌患者进行保守治疗是合理的。
