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題名 | Recurrence and Progression of Stage T1 Superficial Bladder Cancer=表淺性膀胱癌第一期之復發性及侵犯性 |
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作者姓名(中文) | 林嘉祥; 楊啟瑞; 歐宴泉; 高育琳; 程千里; | 書刊名 | 中華民國泌尿科醫學會雜誌 |
卷期 | 9:1 1998.03[民87.03] |
頁次 | 頁1-6 |
分類號 | 416.274 |
關鍵詞 | 表淺性膀胱癌; 移形細胞癌; 膀胱內化學灌注; 復發; 侵犯; Superficial bladder cancer; Transitional cell carcinoma; Intravesical chemotherapy; Recurrence; Progression; |
語文 | 英文(English) |
中文摘要 | 從1982年10月至1996年3月,總數86位表淺性膀胱癌第一期病人於本院接受 經尿道切除腫瘤及輔助性膀胱內化學治療。原位癌已經在文獻上被證實為疾病復發及侵犯的 高危險因子,因此被排除在本研究之外。平均年齡為63.9歲(38~84),平均追蹤時間為60.2 個月(13~163)。 所有的病人皆在全身麻醉下接受骨盆腔兩手式的檢查。膀胱癌標本則根據不同的深度分 次切除。細胞分化等級依據UICC-3分類系統判定。輔助性膀胱內化學治療則選擇性在高危 險群實施。86位病人根據腫瘤細胞分化等級是否接受膀胱內化學灌注治療分為四組:第一 組TIG2無膀胱內化學灌注治療22人,第二組TIG2有膀光內化學灌注治療16人,第三組 TIG3無膀胱內化學灌注治療18人,第四組TIG3有膀胱內化學灌注治療30人。四組平均 復發率分別為72.7%,75%,83.3%及83.3%。第一期膀胱癌概括復發率為80.2%,概括侵犯 率為22.1%,TIG2疾病相對TIG3疾病的侵犯為2.8%相對37.5%(P<0.001),膀胱內化學治 療並未能改變此疾病的侵犯性(第三組比第四組:38.9%比36.7%,P=0.878)。TIG2及TIG3 疾病為兩種不同的疾病已經足夠,然而對TIG3疾病而言,則需要更有效的膀胱內免疫治療 及精確的預後評估參數。 |
英文摘要 | From October 1982 to March 1996, a total of 86 patients with superficial transitional cell carcinoma of bladder, stage T1, were treated with transurethral resection and adjuvant in-travesical chemotherapy in our hospital. Carcinoma in situ is documented as high risk of recurrence and progression of disease and was therefore excluded from this study. The mean age was 63.9 years (range 38-84). The mean follow-up period was 60.2 months (range 13-163). Bimanual exams under general anesthesia were routinely performed. Fractionate resections of various depths were sent. Grading method was judged by UICC-3 classification system. Adjuvant in-travesical chemotherapy was performed in high risk groups. 86 patients were divided into four groups according to grade and whether they would undergo intravesical instillation (IVI) chemotherapy or not: Group I TIG2 without IVI(22), group II TIG2 with IVI(16), group III TIG3 without IVI(18), and group IV TIG3 with IVI(30) with IVI(30). The average recurrence rates were 72.7%, 75%, 83.3%, and 83.3% in group I,II,III and IV respectively. The overall recurrence rate of T1 category disease was 80.2%. The overall progression rate was 22.1%. The progression rate of TIG2 disease versus that of TIG3 disease was 2.8%versus 37.5% (p<0.001). Intravesical chemotherapy did not alter the progression of the disease (group III vs. group IV: 38.9% vs. 36.7%, p=0.878). TIG2 and TIG3 disease represent two different disease entities. Traditional treatment and close follow-up are sufficient for TIG2 disease, but more effective intravesical immunotherapy and precise prognostic paramenters are recommended for TIG3 disease. (J Urol R.O.C., 9:1-6, 1998) |
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