ABSTRACT
Bladder cancer (BC) is the tenth most common cause of cancer worldwide and is the thirteenth leading cause of cancer mortality. The non-muscle invasive (NMI) variant represents 75% of cases and has a mortality rate of less than 1%; however, it has a high recurrence rate. The gold standard of management is transurethral resection in the case of new lesions. However, this is associated with significant morbidity and costs, so the reduction of these procedures would contribute to reducing complications, morbidity, and the burden to the health system associated with therapy. In this clinical scenario, strategies such as active surveillance have emerged that propose to manage low-risk BC with follow-up; however, due to the low evidence available, this is a strategy that is underutilized by clinicians. On the other hand, in the era of biomarkers, it is increasingly known how to use them as a tool in BC. Therefore, the aim of this review is to provide to clinical practitioners the evidence available to date on AS and the potential role of biomarkers in this therapeutic strategy in patients with low-grade/risk NMIBC. This is the first review linking use of biomarkers and active surveillance, including 29 articles.
Subject(s)
Biomarkers, Tumor , Non-Muscle Invasive Bladder Neoplasms , Humans , Non-Muscle Invasive Bladder Neoplasms/diagnosis , Watchful Waiting/methodsABSTRACT
Background: Aggressive angiomyxoma (AA) is a rare tumor that usually appears in the female pelvic and perineal regions. It commonly has infiltrative behavior and high local recurrence risk. We report an unusual presentation of AA, originating in a female patient's bladder. Case Report: A 43-year-old female patient presented with recurrent urinary tract infection for 6 months; ultrasonography showed a bladder tumor that was diagnosed as AA by immunohistochemistry and treated with complete transurethral resection. Conclusion: Transurethral resection can be an effective approach for the treatment of AA.
ABSTRACT
OBJECTIVE: This work aims to evaluate the effectiveness of a second transurethral resection for muscle-invasive bladder tumours. The clinical literature of 15 cases of patients with muscle-invasive bladder cancer treated by second transurethral resection of bladder tumours (TURBT) was analysed. METHODS: The operation was based on the principle of TURBT down to the fatty layer outside the bladder wall. A second transurethral resection was performed four to six weeks after the initial resection. All patients received intravesical chemotherapy postoperation. Fifteen cases were followed-up for three to 26 months, with a mean period of 14 months. RESULTS: After the second transurethral resection, residual tumours were found in two patients. All patients underwent computed tomography scan and biopsy. No patient had a recurrence of the tumour. Eighty per cent of the patients had normal bladder function and 20% had mild-to-moderate lower urinary tract symptoms. All patients had a high quality of life. CONCLUSIONS: A second TURBT is suitable for muscle-invasive bladder cancer when bladder preservation is planned as it prolongs the survival time and improves the patients' quality of life.
OBJETIVO: Este trabajo tiene como objetivo evaluar la eficacia de una segunda resección transuretral de los tumores vesicales con invasión de la capa muscular. Se analizó la literatura clínica de 15 casos de pacientes con cáncer de la vejiga con invasión muscular, tratados con segunda resección transuretral de los tumores de la vejiga (TURBT). MÉTODOS: La operación se basó en el principio de TURBT hasta la capa de grasa fuera de la pared de la vejiga. De cuatro a seis semanas después de la resección inicial, se realizó una segunda resección transuretral. Todos los pacientes recibieron quimioterapia intravesical postoperatoria. Quince casos tuvieron seguimiento de tres a 26 meses, con un período promedio de 14 meses. RESULTADOS: Después de la segunda resección transuretral, se hallaron tumores residuales en dos pacientes. A todos los pacientes se les hizo una biopsia y una tomografía computarizada. Ningún paciente tuvo una recidiva del tumor. Ochenta por ciento de los pacientes tenían una función vesical normal, en tanto que un 20% presentaban síntomas de las vías urinarias de leves a moderadamente bajos. Todos los pacientes tenían un alto nivel de vida. CONCLUSIONES: Es conveniente una segunda TURBT para el cáncer de vejiga con invasión muscular cuando se planea la preservación vesical, ya que prolonga el tiempo de supervivencia y mejora la calidad de vida de los pacientes.