Li Aihua, Fang Wei, Zhang Feng, Li Weiwu, Lu Honghai, Liu Sikuan, Wang Hui, Zhang Binghui
Department of Urology, Yangpu Hospital, School of Medicine, Tongji University Shanghai, China.
Can Urol Assoc J. 2013 Nov-Dec;7(11-12):E812-6. doi: 10.5489/cuaj.363.
We evaluate the efficacy and safety of transurethral resection and degeneration of bladder tumour (TURD-Bt).
In total, 56 patients with bladder tumour were treated by TURD-Bt. The results in these patients were compared with 32 patients treated by current transurethral resection of bladder tumour (TUR-Bt). Patients with or without disease progressive factors were respectively compared between the 2 groups. The factors included recurrent tumour, multiple tumours, tumour ≥3 cm in diameter, clinical stage T2, histological grade 3, adenocarcinoma, and ureteral obstruction or hydronephrosis.
Follow-up time was 48.55 ± 23.74 months in TURD-Bt group and 56.28 ± 17.61 months in the TUR-Bt group (p > 0.05). In patients without progressive factors, no tumour recurrence was found and overall survival was 14 (100%) in the TURD-Bt group; 3 (37.50%) patients had recurrence and overall survival was 5 (62.5%) in the TUR-Bt group. In patients with progressive factors, 8 (19.05%) patients had tumour recurrence, overall survival was 32 (76.19%) and cancer death was 3 (7.14%) in TURD-Bt group; 18 (75.00%) patients had tumour recurrence (p < 0.05), overall survival was 12 (50.00%) (p < 0.01) and cancer death was 8 (33.33%) (p < 0.05) in TUR-Bt group. No significant complication was found in TURD-Bt group.
This study suggests that complete resection and degeneration of bladder tumour can be expected by TURD-Bt. The surgical procedure is safe and efficacious, and could be predictable and controllable before and during surgery. We would conclude that for bladder cancers without lymph node metastasis and distal metastasis, TURD-Bt could be performed to replace radical TUR-Bt and preserve the bladder.
我们评估经尿道膀胱肿瘤切除及变性术(TURD-Bt)的疗效和安全性。
共有56例膀胱肿瘤患者接受了TURD-Bt治疗。将这些患者的结果与32例接受当前经尿道膀胱肿瘤切除术(TUR-Bt)的患者进行比较。对两组中有无疾病进展因素的患者分别进行比较。这些因素包括复发性肿瘤、多发性肿瘤、直径≥3 cm的肿瘤、临床分期T2、组织学分级3级、腺癌以及输尿管梗阻或肾积水。
TURD-Bt组的随访时间为48.55±23.74个月,TUR-Bt组为56.28±17.61个月(p>0.05)。在无进展因素的患者中,TURD-Bt组未发现肿瘤复发,总生存率为14例(100%);TUR-Bt组有3例(37.50%)患者复发,总生存率为5例(62.5%)。在有进展因素的患者中,TURD-Bt组有8例(19.05%)患者肿瘤复发,总生存率为32例(76.19%),癌症死亡3例(7.14%);TUR-Bt组有18例(75.00%)患者肿瘤复发(p<0.05),总生存率为12例(50.00%)(p<0.01),癌症死亡8例(33.33%)(p<0.05)。TURD-Bt组未发现明显并发症。
本研究表明,TURD-Bt有望实现膀胱肿瘤的完全切除及变性。该手术操作安全有效,在手术前和手术过程中具有可预测性和可控性。我们得出结论,对于无淋巴结转移和远处转移的膀胱癌,可进行TURD-Bt以替代根治性TUR-Bt并保留膀胱。