임상적 T2병기 방광이행상피암 환자에서 근치적방광적출술 후 병리학적 T병기 상승을 예측할 수 있는 인자
Predictive Factors of Advancement of the Pathologic T Stage after Radical Cystectomy in Patients with Clinical T2 Stage Bladder Transitional Cell Carcinoma
박서용, 최한용, 이현무,
소속 상세정보
박서용 ( Park Seo-Yong )
성균관대학교 의과대학 비뇨기과학교실
최한용 ( Choi Han-Yong )
성균관대학교 의과대학 비뇨기과학교실
이현무 ( Lee Hyun-Moo )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320070480040390
Abstract
Purpose: We wanted to identify the predictive factors of pathologic over- staging in a homogeneous series of patients who had undergone radical cystectomy for their clinical T2 stage bladder cancer.
Materials & Methods: We retrospectively analyzed the clinicopathological parameter of 53 patients who had undergone radical cystectomy for the management of muscle-invasive transitional cell carcinoma. Of these 53 patients, 44 were men and 9 were women. The mean age was 61.3 years. After dividing the entire cohort into 2 groups according to final pathologic stage(≥pT3 and ≤pT2), we compared the clinicopathological parameters such as the time interval between the initial diagnosis of muscle invasion and cystectomy, the number of transurethral resection of bladder tumors(TURBTs), intravesical immunochemotherapy, the tumor grade, the p53 expression, the presence of carcinoma in situ and the gross findings of transurethral resection of bladder tumor(i.e. tumor size, multiplicity and tumor configuration) between the 2 groups.
Results: The final pathologic stages were ≤pT2 in 31 patients(58.5%), pT3 in 20 patients(37.7%) and pT4 in 2 patients(3.8%). Comparison of the clinical staging with the pathological staging revealed that 22 of the 53 cases(41.5%) were clinically understaged. There were no statistically significant differences between the ≥pT3 and ≤pT2 groups regarding the number of TURBTs, intravesical immunochemotheraphy, tumor grade, the p53 expression, the presence of carcinoma in situ and the gross findings of TURBT. But patients with a time interval of ≥2 months between the diagnosis of muscle invasion and cystectomy had a significantly higher frequency of extravesical disease.
Conclusion: These results underline the need for early treatment with cystectomy, within a 2 month period, once the diagnosis of muscle invasion has been made. (Korean J Urol 2007;48:390-395)
키워드
Bladder neoplasms;Cystectomy;Time factors
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