Lin Guotai,Li Changgui,Zhang Yiming,Zou Zhicong,Liu Yingfa,Lin Yuantian,Wu Yinsuo.Reasons and preventive strategies of post-TUR neoplasm recurrences for superficial transitional cell carcinoma[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(18):1884-1887.
Lin Guotai,Li Changgui,Zhang Yiming,Zou Zhicong,Liu Yingfa,Lin Yuantian,Wu Yinsuo.Reasons and preventive strategies of post-TUR neoplasm recurrences for superficial transitional cell carcinoma[J].J Amry Med Univ (J Third Mil Med Univ),2012,34(18):1884-1887.DOI:
Reasons and preventive strategies of post-TUR neoplasm recurrences for superficial transitional cell carcinoma
Objective To analyze the reason and preventive strategies of neoplasm recurrences after transurethral resection (TUR) for patients with superficial transitional cell carcinoma (STCC). Methods From Jan. 2001 to Jun. 2007
128 randomly STCC patients who had undergone TUR in our hospital and received vesical irrigative chemotherapy merely with Mutamycin C after surgery
were assigned as the control group. Another series of 81 STCC patients in our hospital from July 2007 to Dec 2011 were selected as the observation group
and these patients received vesical irrigative chemotherapy with mutamycin C
as well as interferon after TUR. Of all patients
clinical data such as neoplasm recurrence
chemotherapy schemes and operative procedures
etc. was analyzed and summarized. Subsequently
a discussion on high risks of postoperative recurrences and the preventive measures was made combined with the latest literatures. Results A total of 209 patients were followed up for an average time of 31±3 months
with a total recurrence rate of 28.23%. Twelve patients accepted reoperation and presented a progression in clinicopathologic stage and/or grade. For all patients
the percentages of single
multiple tumors
stage Ta
T1
grade 1
2 and 3 tumors were 23.23%
42.59%
6.25%
34.78%
17.05%
37.25% and 62.07%
respectively. No difference in tumor stages
grades
and numbers was found between observation and control groups (P0.05). The recurrence rate for observation group was significantly lower than control group (14.15% vs 36.72%
P0.01). Furthermore
recurrence rates for single tumors
stage Ta or low grade tumors was significantly lower than multiple tumors
stage T1 or high grade tumors
respectively (P0.01). Conclusion There are various high risks associated with recurrences of STCC patients after TUR
such as those with high grades
at advanced stages
multiple lesions and non-papillary growth patterns of tumors
as well as invisible satellite lesions
omissions of small tumors due to anthropic factors
replantation of residual tumor fragments
failure of irrigative chemotherapy
etc. A standardized thoroughly resection of the primary tumor
combined with normalized vesical irrigative chemotherapy using chemicals and immunoreagents
including chemotherapy instantly after TUR
will promote the clinical outcome and decrease the recurrence rate.