Yucetas Ugur, Aglamis Erdogan, Ates Huseyin Aytac, Behzatoglu Kemal, Erkan Erkan, Toktas Mahmut Gokhan, Unluer Erdinc
Department of Urology, Health Sciences University, Istanbul Training and Research Hospital, Istanbul, Turkey.
Department of Urology, Health Sciences University, Elazig Training and Research Hospital, Elazig, Turkey.
Urol Ann. 2020 Jan-Mar;12(1):25-30. doi: 10.4103/UA.UA_143_18. Epub 2019 Nov 7.
The applicability of cystoscopy follow-up protocol that is indicated for low-risk nonmuscle-invasive bladder cancer (NMIBC) in the guidelines was investigated for our population.
Patients who underwent transurethral resection with a diagnosis of primary bladder tumor in our clinic within 10 years with low grade of pathology pTa and follow-up periods of at least 5 years were retrospectively reviewed. Fifty-one patients (39 males and 12 females) who were diagnosed with a low-risk NMIBC, had no recurrence at the 3-month control cystoscopy, and followed up for the first 2 years on 3-month basis with cystoscopy were included in the study.
The mean age of the patients was 57.37 ± 12.21 years (range: 29-80 years), and the mean duration of recurrence was 25.76 ± 32.45 months. In the cystoscopy follow-ups of 51 patients, up to the 6 month, a total of 12 (24%); up to the 9 month, a total of 21 (41%); up to the 12 month, a total of 30 (59%); up to the 15 month, a total of 36 (71%); up to the 18 month, a total of 36 (71%); up to the 21 month, a total of 39 (77%); and up to the 24 month, a total of 41 (80%) patients were reported to have recurrence. In the case of patients with no recurrence at the 9 month cystoscopy, it was determined that 50% of the patients had recurrence in the first 6 months and 67% in the first 2 years.
The majority (80%) of recurrences in low-risk NMIBC occurred in the first 2 years. If the follow-up protocol described in the guidelines had been applied, patients with relapses would have a delay of at least 6 months of diagnosis. Therefore, even if there is no recurrence in the low-risk NMIBC at the 3 and 9 months, it may be more appropriate to follow the cases in the first 2 years with follow-up cystoscopy every 3 months.
研究指南中针对低风险非肌层浸润性膀胱癌（NMIBC）的膀胱镜检查随访方案在我们人群中的适用性。
回顾性分析在我们诊所10年内接受经尿道切除术且病理分级为低级别pTa的原发性膀胱肿瘤患者，且随访期至少5年。纳入51例（39例男性和12例女性）被诊断为低风险NMIBC、在3个月的膀胱镜检查时无复发且在前2年每3个月进行一次膀胱镜检查随访的患者。
患者的平均年龄为57.37±12.21岁（范围：29 - 80岁），复发的平均持续时间为25.76±32.45个月。在51例患者的膀胱镜检查随访中，到6个月时，共有12例（24%）复发；到9个月时，共有21例（41%）复发；到12个月时，共有30例（59%）复发；到15个月时，共有36例（71%）复发；到18个月时，共有36例（71%）复发；到21个月时，共有39例（77%）复发；到24个月时，共有41例（80%）患者复发。在9个月膀胱镜检查时无复发的患者中，确定50%的患者在最初6个月内复发，67%的患者在最初2年内复发。
低风险NMIBC的大多数复发（80%）发生在最初2年内。如果应用指南中描述的随访方案，复发患者的诊断将至少延迟6个月。因此，即使低风险NMIBC在3个月和9个月时无复发，在前2年每3个月进行一次膀胱镜检查随访这些病例可能更合适。
