Objective:To compare the efficacy and safety of hyperthermic intravesical chemotherapy(HIVEC)and intravesical chemotherapy(IVEC)in patients with intermediate and high risk nonmuscle-invasive bladder cancer(NMIBC)after...Objective:To compare the efficacy and safety of hyperthermic intravesical chemotherapy(HIVEC)and intravesical chemotherapy(IVEC)in patients with intermediate and high risk nonmuscle-invasive bladder cancer(NMIBC)after transurethral resection.Methods:We included 560 patients diagnosed with primary or recurrent NMIBC between April 2009 and December 2015 at 1 of 6 tertiary centers.We matched 364 intermediate or high risk cases and divided them into 2 groups:the HIVEC+IVEC group[chemohyperthermia(CHT)composed of 3 consecutive sessions followed by intravesical instillation without hyperthermia]and the IVEC group(intravesical instillation without hyperthermia).The data were recorded in the database.The primary endpoint was 2-year recurrence-free survival(RFS)in all NMIBC patients(n=364),whereas the secondary endpoints were the assessment of radical cystectomy(RC)and 5-year overall survival(OS).Results:There was a significant difference in the 2-year RFS between the two groups in all patients(n=364;HIVEC+IVEC:82.42%vs.IVEC:74.18%,P=0.038).Compared with the IVEC group,the HIVEC+IVEC group had a lower incidence of RC(P=0.0274).However,the 5-year OS was the same between the 2 groups(P=0.1434).Adverse events(AEs)occurred in 32.7%of all patients,but none of the events was serious(grades 3–4).No difference in the incidence or severity of AEs between each treatment modality was observed.Conclusions:This retrospective study showed that HIVEC+IVEC had a higher 2-year RFS and a lower incidence of RC than IVEC therapy in intermediate and high risk NMIBC patients.Both treatments were well-tolerated in a similar manner.展开更多
Objectives: Surgical specimens obtained at the time of the last transurethral resection of bladder tumor (TURBT) for patients with nonmuscle-invasive bladder cancer (NMIBC) who underwent radical cystectomy were retros...Objectives: Surgical specimens obtained at the time of the last transurethral resection of bladder tumor (TURBT) for patients with nonmuscle-invasive bladder cancer (NMIBC) who underwent radical cystectomy were retrospectively evaluated in order to investigate the relationship between pathological variation and upstaging of NMIBC. Methods and Materials: Twenty patients (19 men, 1 woman;aged 69.4 ± 12.1 (mean ± SD) years) diagnosed with NMIBC underwent radical cystectomy during follow-up. Results: Five of the 20 patients (25%) had pathological upstaging in the radical cystectomy specimens. There was a statistical association between pathological upstaging and cancer death (p = 0.002). There were three patterns of pathological variation in the upstaged specimens: 1) in patients with BCG-resistant NMIBC, urothelial carcinoma invaded through the lamina propria;2) urothelial carcinoma showed diffuse invasion beyond the deep lamina propria, and the cancer cells had infiltrated as single cells and formed nodules;3) TURBT specimens showed a micropapillary variant. Conclusions: Since these pathological variations correlated with pathological upstaging, they may provide an indication for cystectomy in NMIBC patients.展开更多
The aim of this study was to investigate the incidence of erectile dysfunction(ED)in nonmuscle-invasive bladder cancer(NMIBC)patients before and after transurethral resection(TUR)in China.Clinical data from 165 male p...The aim of this study was to investigate the incidence of erectile dysfunction(ED)in nonmuscle-invasive bladder cancer(NMIBC)patients before and after transurethral resection(TUR)in China.Clinical data from 165 male patients with NMIBC who received adjuvant intravesical chemotherapy after TUR in Neijiang First People’s Hospital(Neijiang,China)between January 2010 and June 2019 were retrospectively reviewed.The sexual function of these patients was evaluated before and 1.5 years after initial TUR by the International Index of Erectile Function-5(IIEF-5).An age-specific subanalysis was performed among the patients:<45 years old(Group 1,n=19)and≥45 years old(Group 2,n=146).Before and 1.5 years after TUR,the incidence rates of ED in Group 1 were 15.8%and 52.6%,and those in Group 2 were 54.1%and 61.0%,respectively.The difference between groups was statistically significant at the preoperative stage(15.8%vs 54.1%,P=0.002)but not at the postoperative stage(52.6%vs 61.0%,P=0.562).Compared with the preoperative stage,the incidence of ED at the postoperative stage was increased significantly in Group 1(15.8%vs 52.6%,P=0.017)but not in Group 2(54.1%vs 61.0%,P=0.345).In conclusion,the incidence of ED increased in male NMIBC patients under the age of 45 years after TUR in China.These patients should be offered professional counseling during the follow-up period.展开更多
目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的...目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的效果。方法:回顾性分析2003年5月～2010年12月期间297例接受经尿道膀胱肿瘤电切(transurethral resection of bladder cancer,TURBT)的NMIBC患者的临床病理资料,所有患者均在术后24小时内接受了首次膀胱灌注化疗。按照EORTC量表的评分原则计算出每位患者的复发和进展评分,并根据得分将所有患者进行风险分层。随访各危险组患者术后复发和进展情况,并将分析结果同量表参考值比较。结果:随访时间23～115个月,平均53个月。随访过程中共122例患者(41%)复发,多因素分析显示复发性肿瘤、G2～3级肿瘤和未在TURBT后6小时内进行首次膀胱灌注化疗是复发的独立危险因素;19例患者(6%)术后进展,独立危险因素包括复发性肿瘤、T1期肿瘤、G3期肿瘤和同时存在原位癌。根据EORTC量表进行复发风险分层后,各组间实际复发率差异均有统计学意义(P<0.01);与EORTC量表参考值相比,低危组(0分)1年及5年复发率均低于参考范围;中危患者(1～9分)的1年复发率低于参考范围,而5年复发率与参考范围相近;高危组(10～17分)1年及5年复发率可信区间均包含EORTC量表的参考范围。进展风险分层除低危组(0分)与中低危组(2～6分)间的实际进展率差异无统计学意义(P=0.10)外,其它各组间的差异均有统计学意义(P<0.01);各风险组实际进展率均接近EORTC的参考范围。结论:EORTC量表对于接受术后即刻膀胱灌注化疗的中国NMIBC患者具有预后价值,但低危患者的实际复发率和中危患者的短期实际复发率低于该量表的参考值。展开更多
基金supported by the National Natural Science Foundation of China(Grant No.81972918)the Guangzhou Key Medical Discipline Construction Project Fund+1 种基金the Guangzhou Major Clinical Technology Program(Grant No.2019ZD16)the Guanzhou Municipal Special Clinical Technology Project(Grant No.2019TS40)。
文摘Objective:To compare the efficacy and safety of hyperthermic intravesical chemotherapy(HIVEC)and intravesical chemotherapy(IVEC)in patients with intermediate and high risk nonmuscle-invasive bladder cancer(NMIBC)after transurethral resection.Methods:We included 560 patients diagnosed with primary or recurrent NMIBC between April 2009 and December 2015 at 1 of 6 tertiary centers.We matched 364 intermediate or high risk cases and divided them into 2 groups:the HIVEC+IVEC group[chemohyperthermia(CHT)composed of 3 consecutive sessions followed by intravesical instillation without hyperthermia]and the IVEC group(intravesical instillation without hyperthermia).The data were recorded in the database.The primary endpoint was 2-year recurrence-free survival(RFS)in all NMIBC patients(n=364),whereas the secondary endpoints were the assessment of radical cystectomy(RC)and 5-year overall survival(OS).Results:There was a significant difference in the 2-year RFS between the two groups in all patients(n=364;HIVEC+IVEC:82.42%vs.IVEC:74.18%,P=0.038).Compared with the IVEC group,the HIVEC+IVEC group had a lower incidence of RC(P=0.0274).However,the 5-year OS was the same between the 2 groups(P=0.1434).Adverse events(AEs)occurred in 32.7%of all patients,but none of the events was serious(grades 3–4).No difference in the incidence or severity of AEs between each treatment modality was observed.Conclusions:This retrospective study showed that HIVEC+IVEC had a higher 2-year RFS and a lower incidence of RC than IVEC therapy in intermediate and high risk NMIBC patients.Both treatments were well-tolerated in a similar manner.
文摘Objectives: Surgical specimens obtained at the time of the last transurethral resection of bladder tumor (TURBT) for patients with nonmuscle-invasive bladder cancer (NMIBC) who underwent radical cystectomy were retrospectively evaluated in order to investigate the relationship between pathological variation and upstaging of NMIBC. Methods and Materials: Twenty patients (19 men, 1 woman;aged 69.4 ± 12.1 (mean ± SD) years) diagnosed with NMIBC underwent radical cystectomy during follow-up. Results: Five of the 20 patients (25%) had pathological upstaging in the radical cystectomy specimens. There was a statistical association between pathological upstaging and cancer death (p = 0.002). There were three patterns of pathological variation in the upstaged specimens: 1) in patients with BCG-resistant NMIBC, urothelial carcinoma invaded through the lamina propria;2) urothelial carcinoma showed diffuse invasion beyond the deep lamina propria, and the cancer cells had infiltrated as single cells and formed nodules;3) TURBT specimens showed a micropapillary variant. Conclusions: Since these pathological variations correlated with pathological upstaging, they may provide an indication for cystectomy in NMIBC patients.
文摘The aim of this study was to investigate the incidence of erectile dysfunction(ED)in nonmuscle-invasive bladder cancer(NMIBC)patients before and after transurethral resection(TUR)in China.Clinical data from 165 male patients with NMIBC who received adjuvant intravesical chemotherapy after TUR in Neijiang First People’s Hospital(Neijiang,China)between January 2010 and June 2019 were retrospectively reviewed.The sexual function of these patients was evaluated before and 1.5 years after initial TUR by the International Index of Erectile Function-5(IIEF-5).An age-specific subanalysis was performed among the patients:<45 years old(Group 1,n=19)and≥45 years old(Group 2,n=146).Before and 1.5 years after TUR,the incidence rates of ED in Group 1 were 15.8%and 52.6%,and those in Group 2 were 54.1%and 61.0%,respectively.The difference between groups was statistically significant at the preoperative stage(15.8%vs 54.1%,P=0.002)but not at the postoperative stage(52.6%vs 61.0%,P=0.562).Compared with the preoperative stage,the incidence of ED at the postoperative stage was increased significantly in Group 1(15.8%vs 52.6%,P=0.017)but not in Group 2(54.1%vs 61.0%,P=0.345).In conclusion,the incidence of ED increased in male NMIBC patients under the age of 45 years after TUR in China.These patients should be offered professional counseling during the follow-up period.
文摘目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的效果。方法:回顾性分析2003年5月～2010年12月期间297例接受经尿道膀胱肿瘤电切(transurethral resection of bladder cancer,TURBT)的NMIBC患者的临床病理资料,所有患者均在术后24小时内接受了首次膀胱灌注化疗。按照EORTC量表的评分原则计算出每位患者的复发和进展评分,并根据得分将所有患者进行风险分层。随访各危险组患者术后复发和进展情况,并将分析结果同量表参考值比较。结果:随访时间23～115个月,平均53个月。随访过程中共122例患者(41%)复发,多因素分析显示复发性肿瘤、G2～3级肿瘤和未在TURBT后6小时内进行首次膀胱灌注化疗是复发的独立危险因素;19例患者(6%)术后进展,独立危险因素包括复发性肿瘤、T1期肿瘤、G3期肿瘤和同时存在原位癌。根据EORTC量表进行复发风险分层后,各组间实际复发率差异均有统计学意义(P<0.01);与EORTC量表参考值相比,低危组(0分)1年及5年复发率均低于参考范围;中危患者(1～9分)的1年复发率低于参考范围,而5年复发率与参考范围相近;高危组(10～17分)1年及5年复发率可信区间均包含EORTC量表的参考范围。进展风险分层除低危组(0分)与中低危组(2～6分)间的实际进展率差异无统计学意义(P=0.10)外,其它各组间的差异均有统计学意义(P<0.01);各风险组实际进展率均接近EORTC的参考范围。结论:EORTC量表对于接受术后即刻膀胱灌注化疗的中国NMIBC患者具有预后价值,但低危患者的实际复发率和中危患者的短期实际复发率低于该量表的参考值。
