Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in o...Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in our center from January 2008 to December 2018 were retrospectively reviewed.Patients with>T2N0M0 disease and positive surgical margins and those who received neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded.Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or in the bladder specimen after RC.Kaplan-Meier curves and log-rank tests assessed disease-free survival(DFS).Logistic and Cox regression analyses were performed to identify potential predictors.Results:A total of 236 patients were included in this review,including 207 males,with a median age of 61 years.The median tumor size was 3 cm,and a total of 94 patients had identified pathological T2 stage disease.Complete TURBT was correlated with tumor size(p=0.041),histological variants(p=0.026),and down-staging(p<0.001).Tumor size,grade,and histological variants were independent predictors of complete TURBT.During a median follow-up of 42.7 months,30 patients developed disease recurrence.Age and histological variants were independent predictors of DFS(p=0.022 and 0.032,respectively),whereas complete TURBT was not an independent predictor of DFS(p=0.156).Down-staging was not associated with survival outcome.Conclusions:Complete TURBT was correlated with an increased rate of down-staging before RC.It was not associated with better oncologic outcomes for patients with organ-confined bladder cancer.展开更多
Background We presented the technique and outcomes of laparoscopic radical cystectomy performed in 28 patients with bladder cancer to evaluate its clinical efficacy and feasibility. Methods Among the 28 patients, aged...Background We presented the technique and outcomes of laparoscopic radical cystectomy performed in 28 patients with bladder cancer to evaluate its clinical efficacy and feasibility. Methods Among the 28 patients, aged from 58 to 73 years （mean 68.5 years）, 26 were transitional cell carcinoma grads Ⅱ-Ⅲ and 2 squamous carcinoma. Laparoscopic radical cystectomy plus bladder reconstruction was performed in all cases, among them 15 with ileum, 10 with rectum pouch, and 3 with ureterostomy. The operating time, the blood loss, the intestine function and the complications were observed. Results All procedures were successful. The operating times were 7--10 hours, the blood loss was 400--1500 ml （mean 850 ml）, the intestine function recovered at 72 hours after operation, and all ureteral catheters were removed at 2 weeks after surgery. The results of intravenous urography were hormonal at 3-month, 1-year, and 2-year follow-up after surgery. Conclusions Laparoscopic radical cystectomy for invasive bladder cancer is safe and efficient, with good operating field, reliable hemostasis, mini-invasion, less celiac complications, and rapid recovery. This surgery is worth being extended.展开更多
基金supported by the Fundamental Research Fund for Central Universities(grant 20ykpy179)Medical Science Fund of Guangdong Province(A2020139).
文摘Objectives:To investigate the role of complete transurethral resection of bladder tumor(TURBT)before radical cystectomy(RC)for organ-confined bladder cancer.Materials and methods:Data of patients who underwent RC in our center from January 2008 to December 2018 were retrospectively reviewed.Patients with>T2N0M0 disease and positive surgical margins and those who received neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded.Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or in the bladder specimen after RC.Kaplan-Meier curves and log-rank tests assessed disease-free survival(DFS).Logistic and Cox regression analyses were performed to identify potential predictors.Results:A total of 236 patients were included in this review,including 207 males,with a median age of 61 years.The median tumor size was 3 cm,and a total of 94 patients had identified pathological T2 stage disease.Complete TURBT was correlated with tumor size(p=0.041),histological variants(p=0.026),and down-staging(p<0.001).Tumor size,grade,and histological variants were independent predictors of complete TURBT.During a median follow-up of 42.7 months,30 patients developed disease recurrence.Age and histological variants were independent predictors of DFS(p=0.022 and 0.032,respectively),whereas complete TURBT was not an independent predictor of DFS(p=0.156).Down-staging was not associated with survival outcome.Conclusions:Complete TURBT was correlated with an increased rate of down-staging before RC.It was not associated with better oncologic outcomes for patients with organ-confined bladder cancer.
文摘Background We presented the technique and outcomes of laparoscopic radical cystectomy performed in 28 patients with bladder cancer to evaluate its clinical efficacy and feasibility. Methods Among the 28 patients, aged from 58 to 73 years （mean 68.5 years）, 26 were transitional cell carcinoma grads Ⅱ-Ⅲ and 2 squamous carcinoma. Laparoscopic radical cystectomy plus bladder reconstruction was performed in all cases, among them 15 with ileum, 10 with rectum pouch, and 3 with ureterostomy. The operating time, the blood loss, the intestine function and the complications were observed. Results All procedures were successful. The operating times were 7--10 hours, the blood loss was 400--1500 ml （mean 850 ml）, the intestine function recovered at 72 hours after operation, and all ureteral catheters were removed at 2 weeks after surgery. The results of intravenous urography were hormonal at 3-month, 1-year, and 2-year follow-up after surgery. Conclusions Laparoscopic radical cystectomy for invasive bladder cancer is safe and efficient, with good operating field, reliable hemostasis, mini-invasion, less celiac complications, and rapid recovery. This surgery is worth being extended.
