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三级中心重复经尿道膀胱肿瘤切除术的效用与安全性

Utility and Safety of Repeat Transurethral Resection of Bladder Tumor Performed at a Tertiary Center.

作者信息

Raja Anand, Malik Kanuj, Arunandhichelvan Arulmolichelvan, Kathiresan N, Ravishankar L S

机构信息

Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.

Department of Surgical Oncology, Erode Trust Hospital, Erode, Tamil Nadu, India.

出版信息

South Asian J Cancer. 2020 Jun;9(2):86-89. doi: 10.1055/s-0040-1721213. Epub 2020 Dec 14.

Abstract

Repeat transurethral resection of bladder tumor (ReTURBT) has become an integral part of the management of superficial bladder cancers at various urological centers around the world. Early detection of residual disease, leading to upstaging in some cases, leads to decrease in recurrence rates. Our study aimed to analyze the impact of ReTURBT in detecting residual tumor and tumor recurrences, hence validating the benefits of procedure as a routine.  A total of 152 patients with superficial bladder cancer who were treated at Cancer Institute (WIA) between January 2005 and December 2013 were analyzed and followed up for 3 years.  Of the 152 cases who underwent ReTURBT, 47 patients had residue in the final histopathology of the resected specimen (31%). The overall rate of upstaging to muscle-invasive disease following ReTURBT was 3.3%. The mean follow-up period was 47.13 months, during which 25 (17%) out of 147 patients who underwent ReTURBT had disease recurrence. There was no additional morbidity due to ReTURBT as compared with the primary procedure.  ReTURBT is an effective procedure in treating recurrent tumors also as long as they remain superficial. The procedure when performed with utmost care in experienced hands remains a very safe procedure to be followed as a routine and standard.

摘要

经尿道膀胱肿瘤重复切除术(ReTURBT)已成为全球各泌尿外科中心浅表性膀胱癌治疗不可或缺的一部分。早期发现残留疾病,在某些情况下会导致分期上升,进而降低复发率。我们的研究旨在分析ReTURBT在检测残留肿瘤和肿瘤复发方面的影响,从而验证该手术作为常规操作的益处。

对2005年1月至2013年12月期间在癌症研究所(WIA)接受治疗的152例浅表性膀胱癌患者进行了分析,并随访3年。

在接受ReTURBT的152例病例中,47例患者切除标本的最终组织病理学检查有残留(31%)。ReTURBT后分期上升至肌层浸润性疾病的总体发生率为3.3%。平均随访期为47.13个月,在此期间,147例接受ReTURBT的患者中有25例(17%)疾病复发。与初次手术相比,ReTURBT没有额外的并发症。

只要肿瘤仍为浅表性,ReTURBT也是治疗复发性肿瘤的有效方法。在经验丰富的医生手中极其小心地进行该手术,作为常规和标准操作仍然是非常安全的。

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