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2.
Anticancer Res ; 40(8): 4787-4793, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32727806

RESUMO

BACKGROUND/AIM: Bladder cancer with histological variant (HV) has different morphological features from usual urothelial carcinoma (UC). The aim of this study was to evaluate the oncological outcomes of HV in patients with bladder cancer. PATIENTS AND METHODS: We retrospectively evaluated data from 102 patients with UC of the bladder treated with radical cystectomy between 1998 and 2017. Pathological findings including HV were assigned by one dedicated pathologist. Recurrence-free survival (RFS) and cancer-specific survival (CSS) and overall survival (OS) were estimated by Cox regression models. RESULTS: In total, 26 patients (25.5%) had HV, and the most common variant was squamous differentiation, followed by glandular differentiation and a mixed variant consisted of squamous and glandular differentiation. The presence of HV was associated with RFS and CSS (p=0.018, p=0.036, respectively). CONCLUSION: HV has more aggressive tumor biological features compared to those with pure UC. The presence of HV was associated with poor survival.


Assuntos
Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/cirurgia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Neoplasias Urológicas/patologia , Neoplasias Urológicas/cirurgia , Cistectomia/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Oncologia/métodos , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia
3.
Khirurgiia (Mosk) ; (6): 121-124, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32573544

RESUMO

High incidence of iatrogenic lesions of genitourinary system (during gynecological and oncogynecological operations) followed by urogenital fistulae and great percentage of recurrences after reconstructive surgery justify the need to improve surgical reconstruction of genitourinary organs and urine discharge in these patients. Stage-by-stage surgical treatment of a patient with extensive vesicovaginal fistula is reported in the article. A defect was associated with loss of 2/3 of the volume of tissues of adjacent organs. Multiple operations in various clinics were failed to eliminate the fistula and resulted decrease of bladder capacity up to microcystis.


Assuntos
Intestino Delgado/transplante , Procedimentos Cirúrgicos Reconstrutivos/métodos , Bexiga Urinária/cirurgia , Vagina/cirurgia , Fístula Vesicovaginal/cirurgia , Feminino , Humanos , Tamanho do Órgão , Bexiga Urinária/patologia , Doenças da Bexiga Urinária/etiologia
4.
Gan To Kagaku Ryoho ; 47(1): 135-137, 2020 Jan.
Artigo em Japonês | MEDLINE | ID: mdl-32381883

RESUMO

A 65-year-old male was diagnosed with rectal cancer invading the urinary bladder, swollen para-aorticlymph nodes, and multiple liver metastases in abdominal CT. After 8 courses of mFOLFOX6 plus panitumumab, the rectal cancer, para-aortic lymph nodes metastasis, and liver metastases decreased significantly in size. Rectal cancer and liver metastases were considered resectable, hence low anterior resection of the rectum was performed. Intraoperative frozen section analysis showed negative metastaticinvolvement of the para-aorticlymph nodes and surgical margins of the urinary bladder; therefore, the urinary bladder was completely preserved. Partial resection of the liver was performed 2 months later. In conclusion, the patient showed good surgical and quality of life results. Thus, the bladder-sparing strategy with preoperative chemotherapy could be considered for appropriately selected rectal cancer patients with urinary bladder involvement.


Assuntos
Neoplasias Retais , Bexiga Urinária , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Fluoruracila , Humanos , Leucovorina , Masculino , Terapia Neoadjuvante , Qualidade de Vida , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/cirurgia , Bexiga Urinária/cirurgia
5.
Ann R Coll Surg Engl ; 102(8): e196-e197, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32436735

RESUMO

Bladder cancer is a rare disease in childhood; however, it is one of great clinical significance. Investigation and management follow a tailored approach, which is largely driven by clinical practice patterns in adult patients with the disease. We present the case of bladder cancer in a boy who presented to the primary care practitioner with visible haematuria. This case highlights the need for clinicians to consider malignancy as a possible cause for haematuria when assessing and investigating children with this presenting complaint.


Assuntos
Hematúria , Neoplasias da Bexiga Urinária , Adolescente , Cistoscopia , Hematúria/diagnóstico , Hematúria/etiologia , Hematúria/cirurgia , Humanos , Masculino , Atenção Primária à Saúde , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/cirurgia
6.
Vet Surg ; 49(5): 1043-1051, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32386271

RESUMO

OBJECTIVE: To evaluate the ability of a bipolar sealing device (BSD) to seal canine bladder tissue and to determine the influence of suture augmentation on resistance to leakage of sealed partial cystectomies. STUDY DESIGN: Ex vivo, simple randomized study. SAMPLE POPULATION: Urinary bladders harvested from canine cadavers (n = 23). METHODS: Partial cystectomy of the cranial third of each bladder was performed with a BSD. This seal was augmented with a simple continuous pattern of 4-0 polydioxanone in half of the specimens. A pressure transducer inserted through the ureter measured intraluminal pressure at initial leakage and catastrophic failure as dyed saline was infused via a catheter inserted through the urethra. Initial leakage pressure and pressure at catastrophic failure were compared between sutured and nonsutured sealed partial cystectomies. RESULTS: Sutured sealed cystectomies showed initial leakage at lower pressures compared to non-sutured cystectomies (8.6 vs. 17.7 mm Hg; P = .0365) but were able to sustain greater pressures at catastrophic failure (34.3 vs. 21.8 mm Hg; P = .007). Catastrophic failure occurred along the seam of all nonsutured sealed cystectomies and at the suture holes in 10 of the 12 sutured bladders. CONCLUSION: Partial cystectomies were effectively sealed with a BSD in this canine cadaveric bladder model. Augmentation with a simple continuous suture pattern increased the pressure at which catastrophic leakage occurred but lowered initial leak pressure. CLINICAL SIGNIFICANCE: This study provides evidence supporting the evaluation of BSD use for partial cystectomy in live animals.


Assuntos
Cistectomia/veterinária , Procedimentos Neurocirúrgicos/veterinária , Equipamentos Cirúrgicos/veterinária , Bexiga Urinária/cirurgia , Animais , Cadáver , Cães , Masculino , Pressão , Suturas , Uretra
7.
Int J Clin Pract ; 74(6): e13507, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32267049

RESUMO

PURPOSE: Iatrogenic bladder injury remains a major challenge. We compared the success and reliability of laparoscopic repair of intraperitoneal bladder rupture in patients who had undergone total laparoscopic hysterectomy. METHODS: This retrospective study included patients who underwent total laparoscopic hysterectomy for benign gynaecological cases at a tertiary academic hospital between January 2018 and June 2019. All patient medical records included in the study were reviewed, and the causes, incidence and management of bladder injuries were assessed. RESULTS: There were nine patients. The cause of all the ruptures was iatrogenic, and all were intra-operatively detected. In all patients, bladder injuries occurred in the posterior side of the bladder during vesicouterine dissection. Laparoscopic bladder perforation repair was performed successfully in all patients. No major complications had occurred in any patients after surgery. The foley catheters were removed 6.67 ± 0.7 (5-7) days after surgery. CONCLUSIONS: If performed by well-trained laparoscopic surgeons, laparoscopic hysterectomy could be the best option for appropriate patients. Nevertheless, patients should be well aware of the potential complications in endometriosis and caesarean cases before the procedure, and care should be paid during dissection. When a urogenital injury is suspected or detected the condition must be adequately identified and proper treatment must be performed to avoid postoperative complications and long-term morbidity.


Assuntos
Histerectomia/efeitos adversos , Laparoscopia/métodos , Complicações Pós-Operatórias/cirurgia , Bexiga Urinária/cirurgia , Adulto , Feminino , Humanos , Histerectomia/métodos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Bexiga Urinária/lesões , Bexiga Urinária/fisiopatologia
8.
Arch Esp Urol ; 73(3): 242-247, 2020 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-32240116

RESUMO

INTRODUCTION AND OBJECTIVES: Urethral-vesical and bladder foreign bodies by electric cables are the most uncommon. The objectives of this article are to present the first worldwide case of urethro-vesical foreign body by the cable of a video game and to review the 5 Spanish publications. CLINICAL CASE: 14-year-old male attending the emergency department for urethral cable retention, urethralgia, hypogastric pain and malodorous urine incontinence. Simple abdominal radiography showed a ball of retained cable in the bladder coming out through the meatus. He was operated on by performing a cystotomy. He was discharged 24 hours later. CONCLUSIONS: Urethral and bladder foreign bodies by electric wire are a rare pathology. They can be due to different motivations. The treatment consists of the extraction of the cable, which can be carried out by endoscopic or open surgery depending on the size and morphology of the cable. It is advisable to study the mental state of these patients.


Assuntos
Corpos Estranhos/diagnóstico por imagem , Incontinência Urinária , Jogos de Vídeo , Adolescente , Humanos , Masculino , Uretra/cirurgia , Bexiga Urinária/cirurgia
9.
Am J Clin Pathol ; 154(2): 208-214, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32253420

RESUMO

OBJECTIVES: Bladder cancers invading the muscularis mucosae (MM) are treated differently from those invading the muscularis propria (MP). However, it may be difficult to determine the type of smooth muscle in transurethral resection (TUR) or biopsy specimens. We aimed to investigate the clinicopathologic features of bladder cancers involving smooth muscle of indeterminate type (SMIT) in TUR specimens in comparison with those invading the MM. METHODS: We identified 103 patients with bladder cancer involving SMIT (n = 27) or the MM (n = 76) in TUR specimens. All patients underwent subsequent restaging TUR or cystectomy. RESULTS: Bladder cancer with SMIT invasion showed a significantly higher rate of MP invasion in the subsequent specimens than those invading the MM (52% vs 29%). Lack of MP in the TUR specimens had a significantly higher risk of MP invasion in the subsequent specimens than those with the MP (61% vs 40%). The overall survival time for patients with SMIT invasion was significantly shorter than those with MM invasion. CONCLUSIONS: Bladder cancers with SMIT invasion in TUR specimens show more frequent cancer upstaging in the subsequent specimens and a poorer clinical outcome than those invading the MM, which highlights the importance of a cancer restaging procedure for these patients.


Assuntos
Carcinoma de Células de Transição/patologia , Membrana Mucosa/patologia , Músculo Liso/patologia , Invasividade Neoplásica/patologia , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma de Células de Transição/cirurgia , Cistectomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Membrana Mucosa/cirurgia , Músculo Liso/cirurgia , Resultado do Tratamento , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Urotélio/patologia , Urotélio/cirurgia
10.
Ann Emerg Med ; 76(2): 191-193, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32241747

RESUMO

Pseudo-azotemia is the syndrome of hypercreatininemia and hyperkaliemia without a change in glomerular filtration rate or structure of the kidney. A 57-year-old vulnerable woman with learning difficulties experienced an intraperitoneal bladder rupture in the absence of a pelvic fracture after a fall. It is suspected that the blunt force compression of a distended bladder situated above the bony protection of the pelvis resulted in delayed intraperitoneal bladder rupture. Urinary ascites resulted in pseudo-azotemia because of urinary creatinine reabsorption across the peritoneum. This "apparent" renal failure is fully reversible when diagnosis and treatment are prompt, with normalization of abnormal laboratory-investigation results often within 24 hours.


Assuntos
Acidentes por Quedas , Lesão Renal Aguda/diagnóstico , Ascite/diagnóstico , Creatinina/sangue , Diagnóstico Diferencial , Hiperpotassemia/sangue , Absorção Peritoneal , Ruptura/diagnóstico , Bexiga Urinária/lesões , Traumatismos do Tornozelo , Ascite/etiologia , Cistoscopia , Epilepsia , Feminino , Humanos , Hiperpotassemia/etiologia , Laparotomia , Deficiências da Aprendizagem , Pessoa de Meia-Idade , Ruptura/sangue , Ruptura/complicações , Ruptura/cirurgia , Choque/etiologia , Lesões dos Tecidos Moles , Tomografia Computadorizada por Raios X , Bexiga Urinária/cirurgia
11.
BMC Womens Health ; 20(1): 66, 2020 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-32245454

RESUMO

BACKGROUND: Müllerianosis is a very rare neoplasm composed of two or three Müllerian derived tissues (endosalpinx, endometrium and endocervix). We report the first case of concurrent müllerianosis of the urinary bladder and the umbilicus presenting with umbilical bleeding. CASE PRESENTATION: A 43-year-old Asian premesopausal female, gravida 1, para 1, presented with intermittent umbilical bleeding. An umbilical nodule and a bladder tumor on the posterior wall of the urinary bladder were identified. She underwent transurethral resection of the bladder tumor and excision of the umbilical nodule successively. Diagnosis of müllerianosis was confirmed by the histological and immunological features. No tumor recurrence was noted at 6 months of follow-up. CONCLUSIONS: Müllerianosis is extremely rare and mainly reported in the urinary bladder, and generally affects women of reproductive age. Despite the common presentations of müllerianosis of the urinary bladder including irritative voiding symptoms, abdominal/pelvic pain and gross hematuria, our rare case had no symptom except umbilical bleeding. The possibility of concurrent bladder müllerianosis should be considered when müllerianosis is found at other location. We suggest a surgical intervention to establish the correct pathological diagnosis because it is essential to exclude malignant neoplasms of the urinary bladder. The majority of patients have a favorable prognosis.


Assuntos
Hemorragia/etiologia , Ductos Paramesonéfricos/patologia , Umbigo/irrigação sanguínea , Doenças da Bexiga Urinária/patologia , Bexiga Urinária/patologia , Adulto , Biópsia , Cesárea , Endométrio , Feminino , Hemorragia/diagnóstico , Hemorragia/cirurgia , Humanos , Pré-Menopausa , Doenças Raras , Resultado do Tratamento , Umbigo/patologia , Umbigo/cirurgia , Bexiga Urinária/cirurgia , Doenças da Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/cirurgia
12.
Zhonghua Fu Chan Ke Za Zhi ; 55(2): 120-124, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32146741

RESUMO

Objective: To assess surgical outcomes of implanted porcine small intestinal submucosa (SIS) mesh in the rabbit vesicovaginal space (VVS) and explore its application value in pelvic floor reconstruction surgery. Methods: Sixteen male rabbits were randomly divided into four groups, and each group had four rabbits. All groups of rabbits were implanted with SIS mesh in the vesicovaginal space. They were humanely killed after a postoperative period of 7, 30, 90 and 180 days by group. The grafted area was removed with the surrounding bladder and vaginal tissues. The specimens were embedded in paraffin and then stained with HE and Masson's trichrome stains for visual observations, cells counts, and assessment of tissues and collagen fibers. Results: (1) After HE staining, a large number of inflammatory response cells mainly eosinophils and lymphocytes infiltrated around the SIS mesh in 7 days group, and neovascularization was observed, the infiltration area of inflammatory response cells further increased in 30 days group, the infiltration area of inflammatory response cells significantly reduced in 90 days group, while the inflammatory response basically subsided in 180 days group. (2) After Masson's trichromestaining, the collagen structure of SIS mesh in 7 days group was clear and intact. While, the collagen structure of SIS mesh was partially degraded in 30 days group, the SIS meshes of 4 rabbits were completely degraded, but the collagen fragments of SIS remained in 90 days group. In 180 days group, the SIS mesh of all rabbits was degraded, and one of them had the formation of new collagen fibers. Conclusions: SIS mesh implanted into the VVS of rabbits can lead to a transient non infective inflammatory reaction, which could be completely degraded and a small amount of new collagen fibers could be produced after 180 days of implantation. Which shown that SIS mesh should be used cautiously in pelvic floor reconstruction surgery.


Assuntos
Mucosa Intestinal/transplante , Intestino Delgado/transplante , Telas Cirúrgicas , Bexiga Urinária/cirurgia , Animais , Colágeno , Feminino , Masculino , Coelhos , Distribuição Aleatória , Suínos , Bexiga Urinária/patologia
13.
PLoS One ; 15(3): e0230417, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203532

RESUMO

PURPOSE: To assess the association of low- vs. guideline-recommended high-intensity cystoscopic surveillance with outcomes among patients with high-risk non-muscle invasive bladder cancer (NMIBC). MATERIALS & METHODS: A retrospective cohort study of Veterans Affairs patients diagnosed with high-risk NMIBC between 2005 and 2011 with follow-up through 2014. Patients were categorized by number of surveillance cystoscopies over two years following diagnosis: low- (1-5) vs. high-intensity (6 or more) surveillance. Propensity score adjusted regression models were used to assess the association of low-intensity cystoscopic surveillance with frequency of transurethral resections, and risk of progression to invasive disease and bladder cancer death. RESULTS: Among 1,542 patients, 520 (33.7%) underwent low-intensity cystoscopic surveillance. Patients undergoing low-intensity surveillance had fewer transurethral resections (37 vs. 99 per 100 person-years; p<0.001). Risk of death from bladder cancer did not differ significantly by low (cumulative incidence [CIn] 8.4% [95% CI 6.5-10.9) at 5 years) vs. high-intensity surveillance (CIn 9.1% [95% CI 7.4-11.2) at 5 years, p = 0.61). Low vs. high-intensity surveillance was not associated with increased risk of bladder cancer death among patients with Ta (CIn 5.7% vs. 8.2% at 5 years p = 0.24) or T1 disease at diagnosis (CIn 10.2% vs. 9.1% at 5 years, p = 0.58). Among patients with Ta disease, low-intensity surveillance was associated with decreased risk of progression to invasive disease (T1 or T2) or bladder cancer death (CIn 19.3% vs. 31.3% at 5 years, p = 0.002). CONCLUSIONS: Patients with high-risk NMIBC undergoing low- vs. high-intensity cystoscopic surveillance underwent fewer transurethral resections, but did not experience an increased risk of progression or bladder cancer death. These findings provide a strong rationale for a clinical trial to determine whether low-intensity surveillance is comparable to high-intensity surveillance for cancer control in high-risk NMIBC.


Assuntos
Carcinoma de Células de Transição/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , Bexiga Urinária/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células de Transição/diagnóstico , Carcinoma de Células de Transição/epidemiologia , Carcinoma de Células de Transição/patologia , Cistoscopia/métodos , Feminino , Humanos , Masculino , Músculo Esquelético/patologia , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/patologia
15.
Urologiia ; (1): 64-67, 2020 Mar.
Artigo em Russo | MEDLINE | ID: mdl-32191004

RESUMO

BACKGROUND: Laparoscopic radical prostatectomy (LRP) is the most popular treatment method for localized prostate cancer worldwide. This is a technically-demanding procedure with a long learning curve. Therefore, an improvement of the surgical technique is very important in order to simplify training for LRP. Dorsal vein ligation and vesicourethral anastomosis (VUA) are two major problems for surgeons with insufficient experience in LRP. Previous studies have shown that between 50 and 250 procedures are required in order to get necessary skills. AIM: to compare and study the advantages of the "free-tie" technique and interrupted suture during the formation of VUA during learning curve of LRP. MATERIALS AND METHODS: a single-center retrospective analysis was performed by evaluating operational reports, video recordings and histories of patients who were operated at Saint Petersburg Public Hospital of Saint Luca from 2016 to 2018. A total of 114 patients were included in the study, 56 of them were undergone to "free-tie" technique and 48 patients had interrupted suture. All procedures were performed by four surgeons with an experience of less than 100 LRP. The evaluation criteria included the time of formation of VUA, the duration of whole procedure, the duration of bladder catheterization, frequency of anastomotic leak and stress urinary incontinence. RESULTS: For surgeons who learned the technique of LRP, the use of a continuous suture with a self-anchoring V-loc thread allowed to reduce significantly the time of formation of VUA and ligation of dorsal venous plexus. Such a suture is more convenient for the surgeon than interrupted suture and makes LRP more proficient and efficient, allowing to reduce the time of procedure, the duration of catheterization, postoperative complications rate associated with anastomotic leak, and also to lower frequency of stress urinary incontinence and obstruction of VUA. This technique may reduce the period necessary for mastering LRP. CONCLUSION: "Free-tie" VUA is a safer and more effective technique compared to interrupted suture technique during learning curve of LRP. According to our work, this technique allows surgeons with insufficient suturing experience to easily overcome the steep training curve.


Assuntos
Laparoscopia , Neoplasias da Próstata/cirurgia , Anastomose Cirúrgica , Humanos , Curva de Aprendizado , Masculino , Prostatectomia , Estudos Retrospectivos , Suturas , Uretra/cirurgia , Bexiga Urinária/cirurgia
17.
J Laparoendosc Adv Surg Tech A ; 30(5): 603-606, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32119809

RESUMO

Background: As a relatively new approach, popularity of pneumovesicoscopic surgery is increasing, but slower than expected due to complex nature of the procedure with efforts to overcome the difficult steps of the procedure. Bladder fixation is one of the crucial steps of the procedure. In this study, we present a novel and simple T-bar technique to overcome this difficulty. Methods: We retrospectively evaluated 24 consecutive patients (39 ureters) who underwent pneumovesicoscopic surgery with fixation of the bladder wall between December 2017 and September 2019. Results: Fixation by transabdominal suture (TS) was performed in 3 patients, while fixation by thread loops with needle in 3 and T-bar device in 18. Tearing of the bladder wall was encountered in 2 patients in TS, in 2 patients with thread loop groups, but none in the T-bar group. Conversion to open surgery was necessary in 3 patients in the T-bar group, but only 1 was related with the fixation technique. Conclusions: T-bar technique is an inexpensive and simple solution providing stable and reliable bladder wall and working port fixation during pneumovesicoscopy.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Suturas , Bexiga Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos/instrumentação , Adolescente , Criança , Pré-Escolar , Cistoscopia , Desenho de Equipamento , Feminino , Humanos , Lactente , Masculino , Agulhas , Poliuretanos/química , Estudos Retrospectivos , Procedimentos Cirúrgicos Urológicos/métodos
18.
Arch. esp. urol. (Ed. impr.) ; 73(1): 41-46, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192893

RESUMO

INTRODUCCIÓN: El estándar de tratamiento en el CVMI es la cistectomía radical, aunque la RTUv + RTP+ quimioterapia sistémica demuestra resultados comparables a la cistectomía radical en términos de control local y supervivencia global. OBJETIVOS: Evaluar nuestros resultados en terapia trimodal en cáncer de vejiga músculo-invasivo que rechazan la cistectomía radical MÉTODOS: Análisis retrospectivo de 23 pacientes con estadio T3 TVMI tratados con preservación vesical (RTUv + 3 ciclos de gemcitabina, cisplatino+ 64Gy RTP adyuvante). KM estimados y log Rank fueron calculados. RESULTADOS: La mediana de seguimiento fue de 58 meses (15-158). El intervalo libre de enfermedad y la supervivencia global a los 5 años fue de 56% y 64%, respectivamente. La Supervivencia cáncer especifica fue de 67%. No se objetivaron complicaciones grado 3 o más. CONCLUSIONES: Nuestra serie de tratamiento preservación vesical demuestra que el uso de este tratamiento en pacientes debidamente seleccionados que no quieren cistectomía radical es apropiado


INTRODUCCIÓN: El estándar de tratamiento en el CVMI es la cistectomía radical, aunque la RTUv + RTP+ quimioterapia sistémica demuestra resultados comparables a la cistectomía radical en términos de control local y supervivencia global. OBJETIVOS: Evaluar nuestros resultados en terapia trimodal en cáncer de vejiga músculo-invasivo que rechazan la cistectomía radical. MÉTODOS: Análisis retrospectivo de 23 pacientes con estadio T3 TVMI tratados con preservación vesical (RTUv +3 ciclos de gemcitabina, cisplatino+ 64Gy RTP adyuvante). KM estimados y log Rank fueron calculados. RESULTADOS: La mediana de seguimiento fue de 58 meses (15-158). El intervalo libre de enfermedad y la supervivencia global a los 5 años fue de 56% y 64%, respectivamente. La Supervivencia cáncer especifica fue de 67%. No se objetivaron complicaciones grado 3 o más. CONCLUSIONES: Nuestra serie de tratamiento preservación vesical demuestra que el uso de este tratamiento en pacientes debidamente seleccionados que no quieren cistectomía radical es apropiado


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/terapia , Cistectomia/métodos , Tratamentos com Preservação do Órgão , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia , Terapia Combinada , Intervalo Livre de Doença , Invasividade Neoplásica , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Bexiga Urinária/cirurgia
20.
Arch Esp Urol ; 73(1): 41-46, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31950922

RESUMO

INTRODUCTION: The standard of care in muscle invasive bladder cancer is radical cystectomy; however; transurethral resection (TUR) followed by external radiotherapy and systemic chemotherapy demonstrates comparable results with radical cystectomy in terms of local control and survival rates. OBJECTIVES: To evaluate our results of multimodality bladder preservation therapy (BPT) in patients who had muscle-invasive bladder cancer and were reluctant to radical cystectomy. METHODS: The retrospective analysis of twenty-three patients with stage T2 transitional cell bladder cancer that were consecutively treated with BPT was performed. Treatment strategy included radical TUR followed by 3 cycles of cisplatin, gemcitabine combination, and radiotherapy of 64 Gy as adjuvant treatment. The Kaplan-Meier survival estimates and log rank were calculated. RESULTS: Median follow-up time was 58 (15-158) months. Disease-free survival (DFS) and five year overall survival (OS) rates for 23 patients were 55.9% and 63.9%, respectively. Cancer-specific OS was 67%. There were no grade 3 or higher complications. CONCLUSIONS: Our small patient group suggests that BPT can be safely applied in selected cases with bladder cancer or in patients that refused radical cystectomy.


Assuntos
Carcinoma de Células de Transição , Cistectomia , Tratamentos com Preservação do Órgão , Neoplasias da Bexiga Urinária , Carcinoma de Células de Transição/patologia , Carcinoma de Células de Transição/terapia , Terapia Combinada , Cistectomia/métodos , Intervalo Livre de Doença , Humanos , Invasividade Neoplásica , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia , Neoplasias da Bexiga Urinária/cirurgia
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