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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

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 recur-rence 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). Biman-ual exams under general anesthesia were routinely performed. Fractionate resections of various depths were sent. Grading metod 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) che-motherapy or not: Group I T1G2 without IVI(22), group II T1G2 with IVI(16), group III T1G3 without IVI(18), and group IV T1G3 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%. he overall progresson rate was 22.1%. The progression rate of T1G2 disease versus that of T1G3 disease was 2.8% versus 37.5% (p<0.001). Intravesical che-motherapy did ot alter the progression of the disease (group III vs. group IV: 38.9%vs. 36.7% p=0.878). T1G2 and T1G3 diseases represent two different disease entities. Traditional treat-ment and close follow-up are sufficient for T1G2 disease, but more effective intravesical immu-notherapy and precise prognostic parameters are recommended for T1G3 disease. (J Urol R.O.C., 9:1-6,1998)

並列摘要


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 recur-rence 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). Biman-ual exams under general anesthesia were routinely performed. Fractionate resections of various depths were sent. Grading metod 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) che-motherapy or not: Group I T1G2 without IVI(22), group II T1G2 with IVI(16), group III T1G3 without IVI(18), and group IV T1G3 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%. he overall progresson rate was 22.1%. The progression rate of T1G2 disease versus that of T1G3 disease was 2.8% versus 37.5% (p<0.001). Intravesical che-motherapy did ot alter the progression of the disease (group III vs. group IV: 38.9%vs. 36.7% p=0.878). T1G2 and T1G3 diseases represent two different disease entities. Traditional treat-ment and close follow-up are sufficient for T1G2 disease, but more effective intravesical immu-notherapy and precise prognostic parameters are recommended for T1G3 disease. (J Urol R.O.C., 9:1-6,1998)

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