정위성 방광대치술 후 보조항암요법의 안전성: 회장도관술과의 비교
Safety of Adjuvant Chemotherapy after Orthotopic Bladder Substitution: Comparison to Ileal Conduit
김광택, 여운걸, 이은식,
소속 상세정보
김광택 ( Kim Kwang-Taek )
서울대학교 의과대학 서울대학교병원 비뇨기과학교실
여운걸 ( Yeo Woon-Geol )
서울대학교 의과대학 비뇨기과학교실
이은식 ( Lee Eun-Sik )
서울대학교 의과대학 비뇨기과학교실
KMID : 0358320070480111116
Abstract
Purpose: Radical cystectomy with urinary tract reconstruction currently remains the standard treatment for invasive bladder cancer, and adjuvant chemotherapy is usually considered for patients with a clinical stage ＞T2 or nodal metastasis. The aim of this study was to assess the safety of adjuvant chemotherapy in patients with orthotopic bladder substitution in comparison to ileal conduit.
Materials and Methods: We retrospectively analyzed the patients who underwent radical cystectomy and urinary diversion between 1990 and 2005. The patients who underwent adjuvant chemotherapy were stratified into two groups: those who had orthotopic bladder substitution and those who had ileal conduit. The chemotherapy regimen, renal function change, complications from adjuvant chemotherapy and other relevant data were analyzed.
Results: Overall, 341 patients had radical cystectomy, 89 had adjuvant chemotherapy, 28 had orthotopic bladder substitution and 61 had ileal conduit. The patient characteristics, including age, stage and follow-up, were similar in both groups. In all, 42% of patients had grade 1 toxicity, 16% had grade 2, 14% had grade 3 and 0% had grade 4. No patients had serious organ toxicity and none died. There were no significant differences in the chemotherapy toxicity and renal function change among the two groups.
Conclusions: Adjuvant chemotherapy is safe and well tolerated by patients with either orthotopic bladder substitution or ileal conduit. There was no increased morbidity or mortality due to adjuvant chemotherapy in the patients who had orthotopic bladder substitution. Hence, orthotopic bladder substitution should not be denied to those patients with bladder cancer and who might require adjuvant chemotherapy
키워드
Adjuvant chemotherapy;Urinary diversion;Cystectomy;Bladder cancer
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