非肌肉層侵犯之膀胱腫瘤
在經尿道切除時對於病理報告是否有逼尿肌之分析
曲元正、馮思中、張英勛、莊正鏗、林柏宏、劉忠一
林口長庚紀念醫院外科部 泌尿科系
Analysis of Detrusor Muscle Sampling during Transurethral Resection of Bladder Tumor in Non-muscle Invasive Bladder Cancer
Yuan-Cheng Chu, See-Tong Pang, Ying-Hsu Chang, Cheng-Keng Chuang, Po-Hung Lin, Chung-Yi Liu
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou medical center, Taoyuan, Taiwan
Purpose:
Transurethral resection of bladder tumor (TUR-BT) plays an important role in the treatment and diagnosis of non-muscle invasive bladder cancer (NMIBC). However, the pathology report of the bladder tumor often had no detrusor muscle presentation. In this situation, it is difficult to decided the advanced treatment. Therefore, we analysis that the detrusor muscle presentation influence the prognosis and the factors affect the detrusor muscle presentation.
Materials and Methods:
Retrospective review the pathology report of TUR-BT from 2013 Jan. to 2013 Dec. in Chang Gung Memorial hospital in Linkou. All patients was follow up for at least one-year.
Results:
There are 150 patients underwent TUR-BT at Linkou CGMH in this year. The NMIBC cases was about 100 (66.7%). The pathology report showed detrusor muscle was 37% and no mention of detrusor muscle was 5%. Compared between the detrusor muscle present and the detrusor muscle absent, the mortality rate within 1 year (0% v.s. 3%, p=0.157) and early recurrent rate (14% v.s. 12%, p>0.05) had no significant difference. Besides, larger bladder tumor (>3cm, p=0.037) and high-grade bladder tumor (p=0.018) had higher detrusor muscle presentation rate. There was no difference in age (p=0.298), gender (p=0.454) and primary stage (p=0.383) in detrusor muscle presentation rate.
Conclusions:
In this data, there was no obvious difference of prognosis within 1 year, but need longer time of follow up to prove that. Pathologists rightly mention detrusor muscle when there is a higher probability of invasion. This help the clinic physician for further treatment decision.