非肌层浸润膀胱癌术后再电切的临床意义

Clinical effects of transurethral re-resection (Re-TUR) for patients with non-muscle invasive bladder cancer

目的探讨术后再电切术(Re-TUR)治疗非肌层浸润性膀胱癌的疗效。方法 36例患者在经尿道电切术后4～6周后进行再电切术;同期未行再次电切而常规随访68例,比较2组患者肿瘤复发和进展情况。结果 36例患者中,发现残存肿瘤17例(47.2%),其中肌层浸润肿瘤2例,该2例患者改变了治疗方案。随访12～38个月,平均25个月,肿瘤复发率17.6%(6/34),进展为肌层浸润肿瘤3例(8.8%)。常规随访组肿瘤复发率41.2%(28/68),进展为肌层浸润肿瘤12例(17.6%)。两组患者肿瘤复发率比较,差异有显著性(P<0.05),但肿瘤进展为肌层浸润肿瘤的发生率比较差异无显著性(P>0.05)。结论首次电切术后再电切可以降低非肌层浸润膀胱尿路上皮癌的复发率,但不能减少肿瘤进展的风险。

[Objective] To explore the effects of Re-TUR of the tumor in patients with non-muscle invasive bladder cancer.[Methods] The Re-resections were performed 4～6 weeks after the first transurethral resection in 36 patients from April 2006 to July 2009,who were diagnosed as non-muscle invasive bladder cancer.Routine follow-up was done in another 68 patients who were not performed Re-TUR.The tumor recurrence and progression rates were compared.[Results] Residual tumors were found in 47.2% （17/36） of patients underwent Re-TUR patients,including muscle-invasive tumors in 2 patients.Treatment plans were changed for these 2 patients due to their resection findings.After average observation of 25 months,patients underwent Re-TUR showed lower recurrence rate （P〈0.05）,but the same progression （P〈0.05）.[Conclusion] Re-TUR may reduce recurrence rate in non-muscle invasive bladder cancers.