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[T1G3 of the bladder: our experience]
S Chisena1, D Antonelli, S Bernasconi
1U.O. di Urologia, Busto Arsizio.
Summary
Transurethral resection for bladder tumors (T1 G3 TCC) under 3.5 cm had high recurrence rates. Radical cystectomy showed no disease progression in T1 G3 TCC patients.
Area of Science:
- Urology
- Oncology
Background:
- T1 G3 Transitional Cell Carcinoma (TCC) of the bladder is a high-risk form of non-muscle invasive bladder cancer.
- Accurate staging and appropriate treatment are crucial for managing T1 G3 TCC to prevent disease progression.
Purpose of the Study:
- To evaluate the outcomes of different treatment modalities for T1 G3 TCC of the bladder.
- To compare the efficacy of transurethral resection (TUR-B) versus radical cystectomy in managing T1 G3 TCC.
Main Methods:
- Retrospective analysis of 20 patients with T1 G3 TCC treated between June 1991 and June 1995.
- Patients were categorized based on tumor characteristics (monofocal/multifocal, size, associated CIS) and treated with either TUR-B or radical cystectomy with OINB diversion.
- Follow-up duration averaged 3.2 years.
Main Results:
- Of 11 patients treated with TUR-B for monofocal T1 G3 TCC <3.5 cm, only 3 had no recurrence; 8 experienced relapses or metachronous tumors, with 5 treated with TUR-B + BCG and 3 undergoing cystectomy.
- The 9 male patients treated with radical cystectomy as a first-line treatment for larger or multifocal/complex T1 G3 TCC showed no disease progression after a mean follow-up of 19.8 months.
Conclusions:
- Transurethral resection for T1 G3 TCC, particularly for tumors <3.5 cm, is associated with a high rate of recurrence and subsequent treatments.
- Radical cystectomy appears to be an effective initial treatment for select T1 G3 TCC patients, preventing disease progression.