일차성 T1G3 방광암에서 고유근의 경요도절제 조직 내 포함 여부의 임상적 의미
Prognostic Significance of the Presence of Proper Muscle in the Resected Specimens of Primary T1G3 Bladder Cancer
박진성, 김진범, 안한종,
소속 상세정보
박진성 ( Park Jin-Sung )
울산대학교 의과대학 비뇨기과학교실
김진범 ( Kim Jum-Bum )
울산대학교 의과대학 비뇨기과학교실
안한종 ( Ahn Han-Jong )
울산대학교 의과대학 비뇨기과학교실
KMID : 0358320060470020137
Abstract
Purpose: According to the presence of proper muscle in the resected specimens from primary T1G3 bladder tumors, we compared the prognosis and investigated factors that were predictive of disease progression during the follow-up and upstaging after radical cystectomy.
Materials and Methods: We reviewed the records of 157 patients who were diagnosed with primary T1G3 bladder cancer for the assessment and comparison of disease recurrence, disease progression and patient survival. There were 101 and 56 patients with and without proper muscle in the their transurethral resection(TUR) specimens(T1G3 and T1xG3, respectively); 30 and 20 of these patients, respectively, had undergone immediate cystectomy.
Results: Among the patients who were followed up after transurethral surgery, there were no differences in the survival between the two groups. For the patients treated by immediate cystectomy, the 5-year cancer-specific survival was 100% for the T1G3 patients at a mean follow-up of 54.5 months while it was 76.6% for the T1xG3 patients at a mean follow-up of 46.0 months(p=0.042). With the absence of radiologic findings suggestive of invasive bladder cancer, 55.6% of the T1xG3 patients were upstaged after radical cystectomy, whereas only 12.0% of the T1G3 patients were upstaged(p=0.002). Between the followed-up group and the cystectomy groups, more patients in the cystectomy group had non-papillary shaped bladder tumor(75.0% vs. 38.9%, respectively, p=0.010). Similarly, the T1x- G3 patients who progressed during follow-up or who were upstaged after radical cystectomy had more non-papillary shaped tumor than the patients who were without progression or upstaging(80.1% vs. 38.5%, respectively, p=0.006).
Conclusions: For primary T1G3 bladder cancer, non-papillary shaped tumor without proper muscle in the resected specimen is a risk factor for the progression during follow-up or upstaging after radical cystectomy that should warrant consideration for repeated resection or early cystectomy.
키워드
Bladder neoplasms;Transurethral resection;Cystectomy;Recurrence;Disease progression
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