Clinical significance of residual tumors at repeat transurethral resection in patients with T1 bladd

• 作 者: Jinchao Chen Teng Li Xianghui Ning Shuanghe Peng Jiangyi Wang Nienie Qi Kan Gong
• 机 构: Peking University First Hospital,Beijing 100034,China
• 出 处: 华夏医学论坛·泌尿生殖2015暨亚太性医学年会2015
• 发表日期: 2015年6期
• 关键词: Bladder cancer T1 stage repeat transurethral resection prognosis

　　Objective: We investigated the clinical markers for the prediction of residual tumors at repeat transurethral resection(re-TUR)for patients with T1 bladder cancer and evaluated the effect of the residual tumor on the prognosis of the disease.Methods: We reviewed the clinical data of the patients undergoing transurethral resection of bladder tumor(TURBT)from 2008 to 2015 in our department.Of these,72 patients with the T1 tumors received re-TUR 2-4 weeks after the initial TUR.A total of 65 patients were followed up,and we recorded the events of tumor recurrence,tumor progression,radical cystectomy and cancer specific death.Results: On re-TUR,33.3%(24/72)of the patients had residual tumours.A statistically significant difference was noted between tumour size and possibility of residual tumors at re-TUR.Residual tumors tended to be detected in patients with larger tumors(diameter ≥4 cm)and might be unrelated to tumor grade or number.The mean follow-up period was 24.0 months.Tumour recurrence occurred in 43.1%of the patients(28/65),with 45.0%(9/20)in the patients with residual tumours and 40.0%(18/45)in patients with not(P=0.71).The overall median recurrence-free survival(RFS)was 21.0 month,and there was no significant difference between patients with residual tumours and patients with no residual tumours in RFS(P=0.11).A total of 7.7%(5/65)of the patients suffered recurrence within 3 months,and the rate of tumor progression,the rate of radical cystectomy and cancer specific mortality was 6.2%(4/65),7.7%(5/65)and 3.1%(2/65),respectively.We noticed that the presence of residual tumours at re-TUR was related to the rate of tumor recurrence within 3 months(P<0.001),but was not related to overall recurrence rate,progression rate,rate of radical cystectomy and cancer specific mortality.Conclusions: For patients with T1 bladder cancer,larger tumors could be a predictive marker for residual tumors on re-TUR.The presence of residual tumors is associated with early recurrence,but has no relationship with prognosis of the disease.