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Title: Narrow band Imagingを用いた初回の経尿道的手術(TUR)の病理診断がHigh grade pT1であった筋層非浸潤性膀胱癌に対する2nd TUR
Other Titles: Second Transurethral Resection (TUR) for Bladder Cancer Diagnosed with High Grade pT1 by Initial TUR Under Narrow Band Imaging
Authors: 三田, 耕司  KAKEN_name
小畠, 浩平  KAKEN_name
大原, 慎也  KAKEN_name
加藤, 昌生  KAKEN_name
野村, 直史  KAKEN_name
村田, 大城  KAKEN_name
望月, 英樹  KAKEN_name
Author's alias: Mita, Koji
Kobatake, Kohei
Ohara, Shinya
Kato, Masao
Nomura, Naofumi
Murata, Daiki
Mochizuki, Hideki
Keywords: NBI
Bladder Ca
Second TUR
Issue Date: 31-Dec-2019
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要 = Acta urologica Japonica
Volume: 65
Issue: 12
Start page: 501
End page: 506
Abstract: We evaluated 52 consecutive cases of patients undergoing second transurethral resections (TUR) for non-muscle invasive bladder cancer (NMIBC) in which the patients were diagnosed with high grade pT1 by the initial TUR under narrow band imaging (NBI). The initial TUR under NBI (NBI-TUR) was performed : Systematic intravesical observation under white light imaging (WLI) and NBI was followed by a multiple site biopsy (MSB), after which lesions detected in positive findings were resected completely under NBI. The tumor detection rates under WLI and NBI were calculated separately and compared with endoscopic findings and MSB samples. The second TUR was performed as a resection that included the surrounding mucosa and muscle layer of the initial NBI-TUR scar under WLI observation, 4-8 weeks after the initial NBI-TUR. The patients were divided into two groups : The residual cancer lesion-positive group (NBIR positive), and the residual cancer lesion-negative group (NBIR negative). The tumor detection rate under NBI was more sensitive compared with that under WLI in the initial NBI-TUR (89.4% vs 59.1% p< 0.0001), and the residual cancer detection rate in the 2nd TUR reached 34.6% (18/52). There was no significant difference in the background factors between the NBIR positive and NBIR negative. While the number of cancer lesions detected under NBI was significantly higher than that under WLI in the NMIBCdiagnosed high grade pT1, the rate of cancer lesions that were difficult to identify in the initial NBI-TUR was still high. These findings demonstrate the limitations of the mono-therapeutic effect of NBI-TUR.
Rights: 許諾条件により本文は2021/01/01に公開
DOI: 10.14989/ActaUrolJap_65_12_501
PubMed ID: 31933334
Appears in Collections:Vol.65 No.12

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