在高风险的非肌肉侵入性膀癌中,根据膀成像报告和数据系统,需要进行第二次输尿管切除
Yuki Nakamura1, Soichiro Yoshida1, Yuki Arita2,3
1Department of Urology, Institute of Science Tokyo, Tokyo, Japan.
概括
膀成像报告和数据系统 (VI-RADS) 评分没有预测高风险非肌肉侵入性膀癌 (NMIBC) 患者的残留癌症或结果,这些患者接受了第二次穿尿管切除 (TUR). 对于这些患者,无论VI-RADS分数如何,建议进行第二次TUR.
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.
- 放射学 放射学是一门学科.
背景情况:
- 膀成像报告和数据系统 (VI-RADS) 在非肌肉侵入性膀癌 (NMIBC) 中指导第二次通过尿道切除 (TUR) 的实用性仍然未得到验证.
- 高风险的NMIBC患者往往需要重复 TUR,以确保完全切除瘤和准确的分期.
研究的目的:
- 评估VI-RADS在预测第二次TUR的高风险NMIBC患者的结果方面的有效性.
- 评估VI-RADS得分与残留癌症的存在,上升阶段和重复 TUR 后的存活率之间的相关性.
主要方法:
- 对116名高风险NMIBC患者进行了回顾性分析,这些患者接受了第二次TUR.
- 在最初的TUR之前的磁共振成像 (MRI) 扫描被两名放射科医生使用VI-RADS进行分类.
- 将VI-RADS分数与第二次TUR发现进行比较,包括残留癌症率,pT2上期率以及无复发和无进展的生存率.
主要成果:
- 在第二次 TUR 时,在49% 的病例中检测到残留癌症,其中4.6% 显示肌肉侵袭 (pT2 上期).
- 在VI-RADS得分和第二次TUR的残留癌症或pT2升级率之间没有发现显著的关联.
- 在这个队列中,VI-RADS评分与无复发或无进展的生存率没有相关性.
结论:
- 在高风险NMIBC患者中,很大一部分患者在最初的TUR后有残留癌症或升级阶段的疾病.
- VI-RADS评分不是对接受高风险NMIBC第二次TUR患者的结果的可靠预测指标.
- 对于高风险的NMIBC,无论手术前的VI-RADS评估如何,都应该进行第二次 TUR.
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