初回TUR後に再発した表在性膀胱癌の予後因子

Abstract

初回TUR(経尿道的切除術)後に再発し2回目のTURを行った表在性膀胱癌55例について初発時と再発時における深達度・異型度・腫瘍数, 再発までの期間, 2回目TURにおける術後補助療法の有無を調査し, 再発後の予後に影響を与えた因子は何か検討した.また, 2回目TUR後に再々発した26例について同様の検討を行った.結果, 予後に有意な影響を及ぼしたと思われる因子は認められなかった

About 70% of bladder cancers are superficial at the initial state. If diagnosed at an early stage, the tumor may be resected completely and easily. However, recurrence is seen in many cases. Prognostic factors of recurrence were investigated in 55 cases of bladder cancer newly diagnosed (excluding carcinoma in situ) between 1995 and 2003, and in which complete resection by transurethral resection (TUR) was possible at first recurrence after initial TUR. One- and three-year postoperative non-recurrence rates were 51.9% and 36.3%, respectively. None of the factors studied, i.e., stage, grade, tumor multiplicity (at initial and at first recurrence), change of stage and grade at first recurrence compared with that of initial TUR, duration to recurrence and adjuvant therapy after TUR, were found to influence the prognosis after recurrence. Similar results were obtained for third TUR. Recurred pTa, grade 1 or solitary cancer at initial or at recurrence had the same prognosis as pT1, grade 2-3 or multiple cancers, and careful follow-up is needed.