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在T1阶段膀癌的封闭切除后,我们是否需要重新TUR?

Stephan Levy¹, Sarah Péricart², Anne Sophie Bajeot¹

¹Department of Urology, CHU-Institut Universitaire du Cancer de Toulouse Oncopole, 1 Av Jean Poulhès, 31059, Toulouse, France.

World journal of urology

|August 8, 2024

概括

在高度T1膀癌的阻断切除 (EBR) 之后,第二次看穿尿道切除 (re-TUR) 并没有导致升级到肌肉侵入性疾病. 然而,在21%的患者中发现了残留疾病,这表明需要仔细选择患者重新TUR.

科学领域:

尿瘤学尿瘤学
膀癌研究膀癌研究
手术病理学手术病理学

背景情况:

第二次看透尿道切除 (re-TUR) 是高度T1 (T1HG) 膀癌诊断后的标准.
关于在块切除 (EBR) 后重复TUR结果的数据有限,特别是在初级切除部位的残留疾病方面.

研究的目的:

为了确定最初用EBR治疗T1HG膀癌的患者在重复TUR后残留疾病 (RD) 和上升阶段的发生率.
具体评估前T1疾病切除痕上的病理发现.

主要方法:

在两个中心 (01/2014-06/2022) 为T1HG泌尿腺癌进行EBR后重新TUR的75名患者的回顾性分析.
主要终点:RD的速度,包括上升到T2的速度,主要切除痕.
二级终点:在初始EBR领域之外的RD率.

主要成果:

在重复TUR时,没有发现肌肉侵入性膀癌 (MIBC).
在16名患者 (21.3%) 检测到残留性疾病 (RD),其中4例 (5.3%) 位于切除痕上.
所有的痕阳性RD病变都是乳头状和高度的;12名患者 (16%) 在最初的EBR领域之外有RD.

结论:

对T1HG膀癌的EBR后的re-TUR在这个队列中没有导致MIBC的升级.
在最初的切除部位内外,仍然存在大量的残留 papillary 疾病.
预测因素,如初始瘤负担和相应的 carcinoma in situ (CIS) 可能有助于选择那些将受益于重新TUR的患者.

关键词:

膀瘤是什么意思膀瘤是什么意思整体切除在整体切除中.高等级的T1 高等级的T1 在瘤学瘤学.第二次看看看.通过尿道切除膀.泌尿器科泌尿器科泌尿器科泌尿器科

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