Abstract:
Non-muscle-invasive bladder carcinoma often occurs in older adults, who often also have urinary dysfunction. The residual urine volume is an important indicator of urinary dysfunction. However, the impact of the residual urine volume on intravesical recurrence remains unclear. In the present study, we analyzed the data of 372 patients at high or very high risk of cancer progression according to the Japanese Urological Association classification who had undergone transurethral resection of a bladder tumor. In univariate analysis, postoperative absence of intravesical Bacillus Calmette-Guérin (BCG) induction was an independent risk factor for intravesical recurrence (hazard ratio 1.94, absence versus presence, p = 0.0019). The incidence of intravesical recurrence did not significantly differ between the mild, intermediate, and severe residual urine groups in the total cohort. Among the BCG-treated cohort, the three groups showed similar trends. Among the non-BCG-treated cohort, although the patients with more than 100 ml of residual urine tended to have more intravesical recurrence than patients with a smaller residual urine volume, this difference did not reach statistical significance. BCG treatment is recommended for patients at high risk of bladder carcinoma. Patients with a large residual urine volume without BCG treatment may be at high risk of intravesical recurrence.
摘要:
非肌层浸润性膀胱癌常发生于老年人,他们也经常有排尿功能障碍。残余尿量是泌尿功能障碍的重要指标。然而,残余尿量对膀胱内复发的影响尚不清楚.在本研究中,根据日本泌尿外科协会分类,我们分析了372例接受过膀胱肿瘤电切术的癌症进展高风险或极高风险患者的数据.在单变量分析中,术后无膀胱内卡介苗(BCG)诱导是膀胱内复发的独立危险因素(风险比1.94,无与有,p=0.0019)。膀胱内复发的发生率在轻度患者之间没有显着差异,中间,和严重残余尿组的总队列。在卡介苗治疗的队列中,三组表现出相似的趋势。在非卡介苗治疗的队列中,尽管残余尿量超过100毫升的患者比残余尿量较小的患者倾向于膀胱内复发更多,这一差异没有达到统计学意义.BCG治疗推荐用于膀胱癌高危患者。未经卡介苗治疗的残余尿量大的患者可能存在膀胱内复发的高风险。