CAJ | 학술논문

目的：探讨经尿道膀胱肿瘤二次电切术(二次电切)治疗多发Ta期膀胱尿路上皮癌的临床疗效。方法：回顾性分析58例多发Ta期膀胱尿路上皮癌患者资料。分实验组25例，明确有无肿瘤残留及确切的临床分期，首次电切后4~6周行二次电切。对照组33例，未接受二次电切患者。比较复发率、疾病进展率及无复发生存率。结果：实验组25例患者中，术后病理证实有肿瘤残余6例(24%)，其中2例(8%)临床分期升高。两组术后平均随访时间(15±5.3)个月。两组1年复发率、疾病进展率差异无统计学意义(P>0.05)；3年、总复发率及无复发生存率差异明显(P<0.05)。结论：二次电切可以降低多发Ta期膀胱尿路上皮癌肿瘤残留率，并可以减少肿瘤的远期复发率及改善无复发生存率，但是在降低近期复发率及疾病进展率方面则无意义。
목적：탐토경뇨도방광종류이차전절술(이차전절)치료다발Ta기방광뇨로상피암적림상료효。방법：회고성분석58례다발Ta기방광뇨로상피암환자자료。분실험조25례，명학유무종류잔류급학절적림상분기，수차전절후4~6주행이차전절。대조조33례，미접수이차전절환자。비교복발솔、질병진전솔급무복발생존솔。결과：실험조25례환자중，술후병리증실유종류잔여6례(24%)，기중2례(8%)림상분기승고。량조술후평균수방시간(15±5.3)개월。량조1년복발솔、질병진전솔차이무통계학의의(P>0.05)；3년、총복발솔급무복발생존솔차이명현(P<0.05)。결론：이차전절가이강저다발Ta기방광뇨로상피암종류잔류솔，병가이감소종류적원기복발솔급개선무복발생존솔，단시재강저근기복발솔급질병진전솔방면칙무의의。
Objective:To explore the clinical significance of second transurethral resection (TUR) in patients with multiple Ta urothelial carcinoma of the bladder.Methods:58 patients with multiple Ta urothelial carcinoma were retrospectively reviewed.Of these cases,25 ones underwent second transurethral resection of bladder tumor(TURBT)(experimental group)after 4~6 weeks of the first TURBT to detect the residual tumors and confirm the exact clinical stage.Tumor recurrence rate,progression rate and recurrence-free survival were also compared with the other 33 cases who didn’t undergo the second TURBT(control group).Results:Experimental group of 25 patients, residual tumor pathologically confirmed six cases(24%), 2 patients(8%) clinical stage increased. The average postoperative follow-up time (15±5.3) months. Two one-year recurrence rate, rate of disease progression was no significant difference (P>0.05);3 years, the overall recurrence rate and recurrence-free survival significantly different (P<0.05). Conclusion:Second TUR decreases the residual rate of multiple Ta urothelial carcinoma of the bladder.It is beneficial to decrease the long-term recurrence rate and improves the recurrence-free survival.However,no statistical significances can be seen as for the short-term recurrence rate and tumor progression rate.