Bretton P R, Herr H W, Whitmore W F, Badalament R A, Kimmel M, Provet J, Oettgen H F, Melamed M R, Fair W R
Department of Surgery (Urology Service), Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
J Urol. 1989 Apr;141(4):853-6. doi: 10.1016/s0022-5347(17)41031-7.
A total of 23 patients presenting with multifocal superficial bladder cancer and concomitant in situ transitional cell carcinoma of the prostatic urethra (mucosal in 19 and ductal in 4) underwent transurethral resection and intravesical bacillus Calmette-Guerin therapy. Median followup was 51.6 months (range 6 to 105 months). Of the 23 patients 13 (48 per cent) had a complete response with a median followup of 43.7 months without recurrence. Progression of some type (local, muscle invasion or metastasis) occurred in 10 patients (44 per cent); none occurred in the prostatic urethra. Median interval free of progression was 55.7 months; 7 of 10 patients required cystectomy for progression or refractory disease in the bladder (prostate negative for transitional cell carcinoma). A trial of complete transurethral resection plus intravesical bacillus Calmette-Guerin is a viable alternative to immediate radical cystectomy for patients with mucosal and/or ductal involvement of the prostatic urethra with in situ transitional cell carcinoma.
共有23例患有多灶性浅表性膀胱癌并伴有前列腺尿道原位移行细胞癌（19例为黏膜型，4例为导管型）的患者接受了经尿道切除术及膀胱内卡介苗治疗。中位随访时间为51.6个月（范围6至105个月）。23例患者中，13例（48%）获得完全缓解，中位随访43.7个月无复发。10例患者（44%）出现某种类型的进展（局部、肌层浸润或转移）；前列腺尿道均未出现进展。无进展的中位间隔时间为55.7个月；10例患者中有7例因膀胱进展或难治性疾病需要行膀胱切除术（前列腺移行细胞癌阴性）。对于前列腺尿道黏膜和/或导管受累伴原位移行细胞癌的患者，完全经尿道切除术加膀胱内卡介苗治疗试验是即刻根治性膀胱切除术的可行替代方案。
