針對表淺性膀胱癌同時進行經尿道膀胱腫瘤刮除及攝護腺刮除是否安全之臨床分析
呂謹亨1、林子平1,2,3、范玉華1,2,3、林志杰1,2,3、黃逸修1,2,3、鍾孝仁1,2,3、郭俊逸1,2,3、吳宏豪1,2,3 、黃志賢1, 2, 3、張延驊1,2,3、林登龍1,2,3
台北榮民總醫院 外科部 泌尿科1 ；國立陽明大學醫學院 泌尿學科2 ；書田泌尿科學研究中心3
Analysis of simultaneous transurethral resection of bladder cancer and prostate in non-muscle invasive bladder urothelial carcinoma patients.
Chin Heng Lu1, Tzu-Ping Lin1,2,3, Y.H. Fan1,2,3, Chih-Chieh Lin1,2,3, Yi-Hsiu Huang1,2,3, Hsiao-Jen Chung1,2,3, Junne-Yih Kuo1,2,3, Howard H.H Wu1,2,3, William J.S. Huang1, 2, 3, Yen-Hua Chang1,2,3Alex Tong-Long Lin1,2,3
1Division of Urology, Department of Surgery, Taipei Veterans General Hospital 2Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan 3Shutien Urological Science Research Center, Taipei, Taiwan
Objective: Currently, the safety and clinical outcome of simultaneous transurethral resection of bladder cancer and prostate (TURBT plus TURP) for patients with non-muscle invasive bladder cancer (NMIBC) and benign prostatic hyperplasia (BPH) is still unclear. The aim of this study is to provide evidence whether simultaneous TURBT/TURP in the treatment of NMIBC with BPH is feasible.
Methods: We retrospectively reviewed NMIBC patients Between January 2000 and December 2015, 809 patients received TURBT at Taipei Veterans General Hospital. Age, CKD, DM, HTN, hemodialysis, tumor stage, grade, multi-focality, coexistence of Cis, recurrence and progression condition, simultaneously TURP or not were investigated.
Results: Of the 809 NMIBC patients who received TURBT (BT group), 38 patients received TURP simultaneously (BT+P group). Mean follow-up time was 75.2±54.3 months. Mean Age was 73.7±12.3 years old. The recurrence rates of BT and BT+P groups were 358/809=44.3% and 9/38=23.7% respectively. Patients who received simultaneous TURBT/TURP had significant lower bladder tumor recurrence rate (P=0.009). For all patients, the recurrence rate was significant higher in multifocal (P<0.0001), higher T stage (P=0.033), Grade (P=0.013) and coexistence of Cis (P=0.002). The progression rate was significant higher in CKD (P=0.005), multifocal (P=0.002), higher T stage (P=0.002), Grade (P<0.0001) and coexistence of Cis P<0.0001). There was no patient had prostate urethral urothelial carcinoma invasion after simultaneous TURBT/TURP.
Conclusion: Patients with NMIBC and BPH received simultaneous TURBT/TURP have significant lower bladder tumor recurrence rate. There was no patient having prostate urethral urothelial carcinoma invasion after simultaneous TURBT/TURP in our study. TURBT/TURP didn’t increase lower urinary tract recurrence of urothelial cancer in our series.