Kimura Yusuke, Honda Masashi, Morizane Shuichi, Hikita Katsuya, Isoyama Tadahiro, Ono Koji, Koumi Tsutomu, Takahashi Chihiro, Takenaka Atsushi
Division of Urology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
Torrori Prefectual Central Hospital, Tottori 680-0901, Japan.
Yonago Acta Med. 2019 Jun 20;62(2):191-197. doi: 10.33160/yam.2019.06.003. eCollection 2019 Jun.
To evaluate the efficacy of Bacilli Calmette-Guerin (BCG) induction instillation therapy after second transurethral resection (TUR) in stage Ta T1 high-grade bladder cancer.
We performed a retrospective analysis of 49 consecutive new onset Ta T1 high-grade bladder cancer patients treated with second TUR at our affiliated institutions. Residual cancer rate, intravesical recurrence-free survival (RFS), and risk factors related to RFS were evaluated by univariate and multivariate Cox proportional hazard model analyses.
Thirty-one patients received BCG therapy after the second TUR (BCG group), and 18 patients were treated with second TUR alone (no BCG group). There were statistically significant differences in the RFS rates between the two groups, ( = 0.037). BCG therapy was the only factor predictive of intravesical recurrence after second TUR in both univariate and multivariate analyses. After the second TUR, BCG therapy significantly decreased intravesical recurrence in the patients with residual tumors ( = 0.014). However, there was no significant difference in intravesical recurrence in the patients with no residual tumors between the two groups ( = 0.359).
BCG therapy after second TUR significantly decreased intravesical recurrence of residual tumors found at the second TUR.
评估卡介苗(BCG)诱导灌注疗法在Ta T1期高级别膀胱癌二次经尿道膀胱肿瘤电切术(TUR)后的疗效。
我们对在我们附属机构接受二次TUR治疗的49例新诊断的Ta T1期高级别膀胱癌患者进行了回顾性分析。通过单因素和多因素Cox比例风险模型分析评估残余癌发生率、膀胱内无复发生存率(RFS)以及与RFS相关的危险因素。
31例患者在二次TUR后接受了BCG治疗(BCG组),18例患者仅接受了二次TUR治疗(无BCG组)。两组的RFS率存在统计学显著差异(=0.037)。在单因素和多因素分析中,BCG治疗是二次TUR后膀胱内复发的唯一预测因素。二次TUR后,BCG治疗显著降低了有残余肿瘤患者的膀胱内复发率(=0.014)。然而,两组中无残余肿瘤患者的膀胱内复发率无显著差异(=0.359)。
二次TUR后进行BCG治疗可显著降低二次TUR时发现的残余肿瘤的膀胱内复发率。