상부요로 이행세포암 환자에서 방광재발의 양상 및 위험인자: 장기 추적 결과
The Patterns and Risk Factors for Subsequent Bladder Recurrence in Patients with Transitional Cell Carcinoma of the Upper Urinary Tract: A Long-Term Follow-Up Study
최현민, 조강수, 조성용, 최영득, 정병하, 홍성준,
소속 상세정보
최현민 ( Choi Hyun-Min )
연세대학교 의과대학 비뇨기과학교실
조강수 ( Cho Kang-Su )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
조성용 ( Cho Soung-Yong )
인제대학교 의과대학 비뇨기과학교실
최영득 ( Choi Young-Deuk )
연세대학교 의과대학 비뇨기과학교실
정병하 ( Chung Byung-Ha )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
홍성준 ( Hong Sung-Joon )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
KMID : 0358320080490040294
Abstract
Purpose : We wanted to evaluate the patterns and risk factors for subsequent bladder recurrence after surgical management for upper urinary tract transitional cell carcinoma(TCC).
Materials & Methods : Between 1986 and 2004, the medical records of the patients who were diagnosed and surgically treated for upper urinary tract TCC were retrospectively analyzed. A total of 215 patients were enrolled in this study, and the median follow-up duration was 53 months (range: 12-240). The bladder recurrence-free survival curve was generated by the Kaplan-Meier method. To investigate the risk factors for subsequent bladder recurrence among the various clinicopathological features, the log rank test and Cox’s proportional hazard model were used.
Results : Recurrence developed in 81 patients(37.7%). Of them, 70 patients (86.4%) had recurred within 24 months, and 76 patients(93.8%) had superficial bladder cancer. Muscle-invasive bladder cancer developed in only 8 patients(9.9%) during follow-up. On univariate analysis, the T stage, age and urine cytology had an influence on bladder recurrence with statistical(borderline) significance. Multivariate analysis revealed that urine cytology was the only independent risk factor for bladder recurrence (p=0.020).
Conclusion : Subsequent bladder recurrence after treatment for upper urinary tract transitional cell cancer usually occurred within two years after surgery, and positive urine cytology is an independent prognostic factor for subsequent bladder recurrence. (Korean J Urol 2008;49:294-299)
키워드
Transitional cell carcinoma; Urinary tract; Bladder; Recurrence; Risk factors
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