Ahmadi Nariman, Delprado Warick J, Brooks Andrew J, Brenner Phillip C, Coombes Graham M, Grant Alexander, Patel Manish I
Urological Cancer Outcomes Centre and Discipline of Surgery, The University of Sydney, Sydney, New South Wales, Australia.
ANZ J Surg. 2015 Mar;85(3):145-9. doi: 10.1111/ans.12383. Epub 2014 Nov 19.
Australian bladder cancer patients especially women are thought to have worse outcomes when compared to the other international series. The objective of this study was to assess the pathological pattern of primary bladder cancer at the time of radical cystectomy as well as assessing the quality of resection in New South Wales.
Pathology reports of radical cystectomy performed for primary bladder cancer were reviewed for a period of 10 years in a single major pathology centre servicing the state of New South Wales.
Two hundred one specimens reviewed over 10 years. The tumour stage at the time of cystectomy was: CIS 29 (14%), Tx,a 5 (2%), T1 24 (12%), T2 49 (24%), T3 57 (28%) and T4 37 (18%). Lymphovascular invasion was seen in 94 (47%). Soft tissue margins were positive in 31 (15%), pelvic lymph node dissection was not performed in 64 (32%) of patients and only 32 (16%) of the patients had 10 or more lymph nodes harvested. No significant differences between men and women were noted in tumour stages, soft tissue positive margin rates and performance of pelvic lymph node dissection. Improving trends were noted in rates of negative soft tissue margins and the lymph node count during this period.
Pattern of disease at the time of cystectomy was similar to the North American and European cohorts. Higher main specimen margin rates as well as lower lymph nodes retrieval rates were observed. No sex discrimination was observed. Further study is recommended to investigate the survival impact of this finding.
与其他国际研究系列相比，澳大利亚膀胱癌患者尤其是女性患者的预后被认为较差。本研究的目的是评估根治性膀胱切除术时原发性膀胱癌的病理模式以及新南威尔士州的切除质量。
在为新南威尔士州服务的单一主要病理中心，回顾了10年间因原发性膀胱癌进行根治性膀胱切除术的病理报告。
10年间共审查了201份标本。膀胱切除时的肿瘤分期为：原位癌（CIS）29例（14%），Tx,a 5例（2%），T1 24例（12%），T2 49例（24%），T3 57例（28%），T4 37例（18%）。94例（47%）可见淋巴管浸润。31例（15%）切缘软组织阳性，64例（32%）患者未进行盆腔淋巴结清扫，只有32例（16%）患者切除了10个或更多淋巴结。在肿瘤分期、切缘软组织阳性率和盆腔淋巴结清扫方面，男性和女性之间未发现显著差异。在此期间，切缘软组织阴性率和淋巴结计数呈上升趋势。
膀胱切除时的疾病模式与北美和欧洲队列相似。观察到较高的主要标本切缘阳性率以及较低的淋巴结获取率。未观察到性别差异。建议进一步研究以调查这一发现对生存的影响。
