上管泌尿道癌的内镜治疗后的瘤监测强度
Giuseppe Basile1,2, Andrea Gallioli3, Alberto Martini4
1Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain - basile.giuseppe@hsr.it.
Minerva urology and nephrology
|March 1, 2024
概括
保守治疗后对上道泌尿道癌 (UTUC) 的最佳监测因风险而异. 低风险患者需要每半年进行24个月的囊镜检查,60个月的上路检查.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 医疗监视 医疗监视
背景情况:
- 在保守管理后,对于上道泌尿道癌 (UTUC) 的最佳瘤监测策略仍在争论中.
- 接受UTUC内镜治疗的患者需要量身定制的随访协议.
研究的目的:
- 评估保守治疗患者的膀癌 (BCa) 和UTUC复发风险.
- 根据疾病风险分层来确定BCa和UTUC复发的最佳监测间隔.
主要方法:
- 卡普兰-梅尔法用于估计无复发和癌症特异性生存率.
- 局部加权分散图平滑 (LOWESS) 用于评估随时间推移的原油复发风险.
- 随访遵循了欧洲泌尿病学协会 (EAU) 的指导方针.
主要成果:
- 在低风险的UTUC患者中,BCa复发风险在24个月后超过20%,在60个月后,BCa的风险为14%,UTUC的风险为7%.
- 高风险的UTUC患者在36个月后约有40%的BCa和10%的UTUC复发,在60个月后有28%的BCa和8%的UTUC复发.
- 复发率突出显示,需要适应风险的监测协议.
结论:
- 对于低风险的UTUC,建议在24个月前进行半年一次囊镜检查,在60个月后进行上道检查.
- 高风险的UTUC患者需要强化半年上部通道评估,直到36个月,然后进行年度检查.
- 建议高风险患者在60个月前进行半年一次囊镜检查,然后过渡到每年一次.
相关概念视频
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...