Urology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
J Urol. 2011 Jun;185(6):2091-6. doi: 10.1016/j.juro.2011.01.082. Epub 2011 Apr 15.
The types of surveillance recommended after radical cystectomy and the degree of patient compliance are not well characterized. We identified the pattern of post-cystectomy surveillance recommended in the oncologic community and assessed compliance to a predetermined schedule among a small group of urologists.
A survey was sent inquiring about the number of patients followed after cystectomy, physician specialty, type of practice, whether the followup schedule was stage dependent, the frequency of office visits and the type of tests. To assess noncompliance to a strict followup schedule we analyzed the records of 647 patients who underwent radical cystectomy.
The overall response rate to the survey was 37% (123 of 330). Of the respondents 96% were urologists, with 72% from United States academic centers, 13% from non-United States academic centers and 14% in private practice. In addition, 21% reported following yearly more than 100 patients after cystectomy, 29% between 51 and 100 patients, and 43% between 1 and 50. Of the respondents 60% tailored the followup schedule based on pathological stage. Computerized tomography of the abdomen and pelvis, chest x-ray and urine cytology were the most frequent tests used. Computerized tomography of the chest, magnetic resonance imaging and abdominal ultrasound were used occasionally.
There was significant deviation from a predetermined followup schedule. There was no uniformity among urological oncologists in post-cystectomy surveillance and there was lack of compliance to a predetermined followup schedule.
根治性膀胱切除术（radical cystectomy）后推荐的监测类型以及患者的依从性程度尚不清楚。我们确定了肿瘤学界推荐的膀胱切除术后监测模式，并评估了一小部分泌尿科医生对预定计划的依从性。
我们发送了一份调查，询问每位接受膀胱切除术的患者的随访人数、医生专业、执业类型、随访计划是否依赖于分期、就诊频率以及检查类型。为了评估严格随访计划的不依从情况，我们分析了 647 例接受根治性膀胱切除术的患者的记录。
对调查的总体回复率为 37%（330 人中的 123 人）。受访者中 96%为泌尿科医生，其中 72%来自美国学术中心，13%来自非美国学术中心，14%来自私人执业。此外，21%的人报告每年随访 100 多名接受膀胱切除术的患者，29%的人随访 51 至 100 名患者，43%的人随访 1 至 50 名患者。60%的受访者根据病理分期制定随访计划。腹部和骨盆计算机断层扫描（CT）、胸部 X 射线和尿液细胞学检查是最常用的检查方法。偶尔会使用胸部 CT、磁共振成像和腹部超声。
与预定的随访计划相比，存在明显的偏差。在膀胱切除术后的监测方面，泌尿外科肿瘤医生之间没有统一的标准，并且对预定的随访计划的依从性不足。
