Tumores Primários Superficiais de Alto Grau da Bexiga

D. S. Pereira, F. Botelho, Carlos Silva, J. S. Silva
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Abstract

Purpose: We aimed to characterize the population with primary high-grade non muscle invasive bladder cancer followed in a Portuguese Central Hospital and simultaneously identify recurrence and progression rates and associated risk factors. Material and Methods: The analysis included 79 patients who were diagnosed with primary high-grade non muscle invasive bladder cancer on first transurethral resection between 2006 and 2010. Several variables were statistically analyzed to evaluate their prognostic importance. Results: With a median follow-up of 54 months, 19 patients (24.1%) recurred, four (5.1%) progressed to muscle-invasive disease and two (2.5%) underwent radical cystectomy. The most important prognostic factor of recurrence was the duration of intravesical bacillus Calmette-Guerin (BCG) treatment while the presence of carcinoma in situ was the most important prognostic factor of progression. Residual disease on second-look transurethral resection showed to reduce the recurrence-free-survival. Conclusion: In our population, recurrence and progression rates were much lower than those described in other studies. Residual disease on second-look transurethral resection is associated with decreased recurrence-free-survival while the presence of carcinoma in situ is related with higher risk of progression. The duration of treatment with BCG seems to reduce the risk of recurrence.
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高级别浅表原发性膀胱肿瘤
目的:我们旨在描述葡萄牙中心医院随访的原发性高级别非肌肉浸润性膀胱癌患者的特征,同时确定复发率和进展率以及相关危险因素。材料和方法:本研究纳入了2006年至2010年首次经尿道膀胱切除术诊断为原发性高级别非肌肉浸润性膀胱癌的79例患者。对几个变量进行统计分析以评估其预后重要性。结果:中位随访54个月,19例(24.1%)复发,4例(5.1%)进展为肌肉侵袭性疾病,2例(2.5%)行根治性膀胱切除术。最重要的预后因素是膀胱内卡介苗治疗的时间,而原位癌的存在是最重要的预后因素。经尿道二次检查切除后的残留病变可降低无复发生存率。结论:在我们的人群中,复发率和进展率远低于其他研究。经尿道二次检查切除的残留病变与无复发生存率降低相关,而原位癌的存在与更高的进展风险相关。卡介苗治疗的持续时间似乎可以降低复发的风险。
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