Kim Bohyun, Choi Hyuck Jae, Kim Mi-Hyun, Cho Kyung-Sik
Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Korea.
Acta Radiol. 2012 Oct 1;53(8):943-9. doi: 10.1258/ar.2012.110700. Epub 2012 Aug 14.
Multidetector computed tomography (MDCT) is widely accepted as an effective imaging modality in monitoring for bladder cancer recurrence after radical cystectomy. Elucidating the pattern of bladder cancer recurrence on CT can increase the diagnostic accuracy.
To evaluate the recurrence patterns of transitional cell carcinoma of the bladder and the factors associated with cancer recurrence.
One hundred and forty-nine consecutive patients (mean age, 66.55 years; range, 32-86 years) who underwent preoperative contrast-enhanced CT and radical cystectomy were included in this study. The presence, site, and time of tumor recurrence were recorded retrospectively by two radiologists in a consensus fashion. The association of tumor recurrence and tumor factors (T stage, lymph node metastasis, nuclear grade, and tumor diameter) were also evaluated using multiple logistic regression analysis and Kaplan-Meier statistics.
Tumor recurrence occurred in 60 patients (40.3%) with a mean time of 14 months (range, 1-64 months). The sites of recurrence included the operation site (n = 20), lymph node (n = 20), bone (n = 11), liver (n = 6), lung (n = 5), upper urinary tract (n = 4), colon (n = 3), adrenal gland (n = 2), peritoneum (n = 1), abdominal wall (n = 1), psoas muscle (n = 1), and penile skin (n = 1). Tumor recurrence was found to be associated with advanced T stage (P = 0.002) and lymph node metastasis (P < 0.001).
Transitional cell carcinomas of the bladder recur more frequently at the operation site and lymph node, and T-stage and lymph node metastasis are closely associated with tumor recurrence.
多排螺旋计算机断层扫描（MDCT）作为一种有效的成像方式，在监测根治性膀胱切除术后膀胱癌复发方面已被广泛接受。阐明CT上膀胱癌复发的模式可提高诊断准确性。
评估膀胱移行细胞癌的复发模式及与癌症复发相关的因素。
本研究纳入了149例连续接受术前增强CT和根治性膀胱切除术的患者（平均年龄66.55岁；范围32 - 86岁）。两名放射科医生以共识的方式回顾性记录肿瘤复发的存在、部位和时间。还使用多元逻辑回归分析和Kaplan-Meier统计评估肿瘤复发与肿瘤因素（T分期、淋巴结转移、核分级和肿瘤直径）之间的关联。
60例患者（40.3%）出现肿瘤复发，平均时间为14个月（范围1 - 64个月）。复发部位包括手术部位（n = 20）、淋巴结（n = 20）、骨（n = 11）、肝（n = 6）、肺（n = 5）、上尿路（n = 4）、结肠（n = 3）、肾上腺（n = 2）、腹膜（n = 1）、腹壁（n = 1）、腰大肌（n = 1）和阴茎皮肤（n = 1）。发现肿瘤复发与晚期T分期（P = 0.002）和淋巴结转移（P < 0.001）相关。
膀胱移行细胞癌在手术部位和淋巴结复发更为频繁，T分期和淋巴结转移与肿瘤复发密切相关。
