Роль повторной трансуретральной резекции в лечении мышечно- неинвазивного рака мочевого пузыря

Аннотация

Objective: In a comparative aspect, select the optimal method of treatment of muscular non-invasive bladder cancer. Materials and methods: The basis of this work was the analysis of the results of the examination and surgical treatment of 57 patients with non-invasive bladder cancer admitted to the Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology from 2014 to 2016 Men were 46 (80.7%), women were 11 (19.3%), the average age was 62 ± 2.4 years. Patients were conditionally divided into 2 groups. The first group (control group), n = 24, underwent transurethral resection (TUR) of the bladder, followed by intravesical instillation with doxorubicin 50 mg, and the second group, n = 33, underwent TUR + repeated TUR (reTUR) + intravesical instillation with doxorubicin 50 mg. Median observation 12 months. Results: During the observation period, 15 (26.3%) recurrences of bladder cancer were observed. In the second group, the recurrence rate was statistically significantly lower (p = 0.02) than in the first group, which was 18.1% and 37.5%, respectively. Correlation analysis for early relapse showed: Group 1 - risk of relapse development (R = 0.56, p = 0.00001) and tumor size (R = 0.45, p = 0.045); in group 2, the risk of relapse (R = 0.38, p = 0.00001) and differentiation of the atypism G (R = 0.15, p = 0.0004). Conclusion: It is statistically justified that performing ReTUR in patients with a gradation of G1-2 malignancy reduces the frequency of relapse. At the same time, with G3 grading after reTUR, one should not wait for relapse and / or progress of the disease, but switch to aggression treatment regimens.