[Interest of reTURB for pTa high grade bladder urothelial carcinoma]. / Intérêt de la résection complémentaire (ou « second look ¼) pour les carcinomes urothéliaux de vessie classés pTa haut grade.
Prog Urol
; 30(1): 19-25, 2020 Jan.
Article
em Fr
| MEDLINE
| ID: mdl-31866142
ABSTRACT
INTRODUCTION:
Second look TURB (Transurethral Resection of Bladder Tumor) is recommended for high-risk pT1 tumors. It is well acquired for tumors classified pT1 high grade but its interest is still discussed for high-grade pTa tumors in the absence of high level of evidence. We evaluated the impact of second-look resection for the high-grade pTa bladder tumor.METHODS:
We performed a retrospective study in 2 centers from 2007 to 2016. We included all urothelial tumors classified pTa high grade. We studied the anatomopathological findings of reTURB and its consequences on survival without recurrence and progression.RESULTS:
Eighty-four patients were included. Thirty-five patients (41.7%) had reTURB and residual tumor was found in 42.9% of cases. The anatomopathology of reTURB was in 20% of cases high grade pTa, in 14.3% of cases pTis, and in 8.6% of cases pT1. Forty-three patients had recurrence, 13 reTURB patients (30.2%). In the patients who had a reTURB, 12 had recurrence (34.3%) against 31 without reTURB, (63.3%). After the first TURB, 45 patients (53.6%) had bladder instillation 38 received BCG (45.2%) and 7 ametycin (8.3%). The main factor decreasing recurrence was BCG adjuvant therapy (HR=0.4 [0.2-0.9], P=0.02). The absence of reRTUV appeared to be a recurrence factor, but the result was not statistically significant (HR=1.4 [0.7-3], P=0.3).CONCLUSION:
reTURB confirms that residual tumor is often found. His interest in survival without recurrence remains to be proved by a prospective study with a larger number of patients. LEVEL OF EVIDENCE 3.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Urológicos
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Neoplasias da Bexiga Urinária
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Carcinoma de Células de Transição
Tipo de estudo:
Observational_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
Fr
Ano de publicação:
2020
Tipo de documento:
Article