MP06: The oncologic benefit of maximal transurethral resection of bladder cancer in muscle invasive bladder tumor
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  • 01-03,
  • 上傳者: TUA秘書處,
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內視鏡膀胱腫瘤廓清於肌肉侵犯性膀胱癌之腫瘤預後利益
沈志宇、蔡育賢、歐建慧、楊文宏
國立成功大學醫學院附設醫院 泌尿部
The Oncologic Benefit of Maximal Transurethral Resection of Bladder Cancer in Muscle Invasive Bladder Tumor
Chih-Yu Shen, Yuh-Shyan Tsai, Chien Hui Ou, Wen Horng Yang
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
 
Purpose: To evaluate the efficacy and oncologic benefit of maximal transurethral resection of bladder tumor (TURBT) followed by radical and partial cystectomy in patients with muscle invasive urothelial carcinoma of the bladder.
Materials and Methods: From 2008 to 2017, a total of 27 patients underwent partial cystectomy with curative intent while 49 patients underwent radical cystectomy in our institution. 12 of which had had no residual tumor in the radical or partial cystectomy specimen after maximal transurethral resection of bladder tumor (TURBT). We retrospectively reviewed the oncologic outcomes including overall survival, recurrence free survival, advance recurrence free survival and disease specific survival of these patients compared with those with residual invasive disease in the radical and partial cystectomy specimen.
Results:For the total of 76 patients receiving surgical treatment, the 5-year overall, recurrence free, disease specific and advance recurrence free survival was 73.7%, 59.9%, 80.2%, and 66.9 % respectively. The 5 year advance recurrence free survival, overall survival, disease specific survival and recurrence free survival for maximal resection group vs. residual tumor group was 100% vs.60.6% (p=0.021), 100% vs 65.2% (p=0.034), 100% vs 76.4 (p=0.082) and 83.3% vs 55.7% (p=0.137), respectively. On univariate analysis gender, pathology stage, adjuvant chemotherapy was related to recurrence free rate and the status of residual tumor was related to advance recurrence, overall survival. On multivariate analysis, adjuvant chemotherapy was predictor of advance recurrence. P=0.038(OR:3.63,95% CI:1.074-12.269)
Conclusions: The status of residual tumor after TURBT is associated with advance recurrence free rate and overall survival. There is a trend toward better disease specific survival and recurrence free survival in the maximal resection group compared to residual tumor group. Longer follow-up with a larger number of patients is necessary to assess its impact on the oncologic outcomes of muscle invasive bladder cancer.
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    發表時間 :
    2019-01-03 14:29:57
    觀看數 :
    120
    發表人 :
    TUA秘書處
    部門 :
    台灣泌尿科醫學會
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