Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press8010.17650/1726-9776-2012-8-1-43-48DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак мочевого пузыряRETROSPECTIVE ANALYSIS OF THE RESULTS OF RADICAL CYSTECTOMY IN NON-MUSCLE INVASIVE BLADDER CANCERРЕТРОСПЕКТИВНЫЙ АНАЛИЗ РЕЗУЛЬТАТОВ РАДИКАЛЬНОЙ ЦИСТЭКТОМИИ ПРИ НЕМЫШЕЧНО-ИНВАЗИВНОМ РАКЕ МОЧЕВОГО ПУЗЫРЯKoganM. I.КоганМ. И.
Russian Federation

Department of Urology and Human Reproductive Health with a Course of Pediatric Urology-Andrology, Rostov State Medical University

кафедра урологии и репродуктивного здоровья человека с курсом детской урологии-андрологии Ростовского ГМУ

dept_kogan@mail.ruVasilyevO. N.ВасильевО. Н.
Russian Federation

Department of Urology and Human Reproductive Health with a Course of Pediatric Urology-Andrology, Rostov State Medical University

кафедра урологии и репродуктивного здоровья человека с курсом детской урологии-андрологии Ростовского ГМУ

dept_kogan@mail.ruResearch Institute of Urology and Nephrology, Rostov-on-DonНИИ урологии и нефрологии, Ростов-на-Дону300320128143482607201426072014https://oncourology.abvpress.ru/oncur/article/view/80

The results of treatment were analyzed in 53 patients with high-risk non-muscle invasive bladder cancer (BC), who had undergone radical cystectomy (RCE) and bilateral pelvic lymphadenectomy. Histological hypostaging was noted in 20.7% of the patients; 13.2% of them had regional lymph node metastases, which confirms the problems associated with the accurate determination of a BC stage in clinical stage T1. The predictors of lower cancer-specific survival were identified in patients after RCE for pT1 cancer. In our study, 5- and 10-year cancerspecific survival was 90.5 and 88.6% in cT1 stage and 98.2 and 96.3% in pT1 stage, respectively. The findings strongly suggest that RCE can afford a long-term high cancer-specific survival in patients with non-muscle invasive BC.

Проведен анализ результатов лечения 53 пациентов с клинически немышечно-инвазивным раком мочевого пузыря (РМП) высокого риска, подвергнутых радикальной цистэктомии (РЦЭ) и двусторонней тазовой лимфаденэктомии. Гистологическое гипостадирование отмечено у 20,7 % пациентов, причем 13,2 % из них имели метастазы в регионарные лимфатические узлы, что подтверждает трудности, связанные с точностью установки стадии РМП при клинической стадии Т1. Определены факторы прогноза сниженной канцерспецифической выживаемости у больных после РЦЭ при рТ1. В нашем исследовании показатели 5- и 10-летней канцерспецифической выживаемости составили 90,5 и 88,6 % при сТ1 и 98,2 и 96,3 % при рТ1. Данные результаты убедительно свидетельствуют о возможности обеспечения методом РЦЭ долговременной высокой канцерспецифической выживаемости больных немышечно-инвазивным РМП.

non-muscle invasive bladder cancerradical cystectomysurvivalcarcinoma in situhypostagingнемышечно-инвазивный рак мочевого пузырярадикальная цистэктомиявыживаемостьрак in situгипостадирование1. Babjuk M., Oosterlinck W., Sylvester R. et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2008;54:303–14.Babjuk M., Oosterlinck W., Sylvester R. et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 2008;54:303–14.2. Hall M.C., Chang S.S., Dalbagni G. et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol 2007;178:2314–30.Hall M.C., Chang S.S., Dalbagni G. et al. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol 2007;178:2314–30.3. Heney N.M. Natural history of superficial bladder cancer. Prognostic features and longterm disease course. Urol Clin North Am 1992;19:429–33.Heney N.M. Natural history of superficial bladder cancer. Prognostic features and longterm disease course. Urol Clin North Am 1992;19:429–33.4. Shelley M.D., Court J.B., Kynaston H. et al. Intravesical bacillus Calmette-Guerin versus mitomycin C for Ta and T1 bladder cancer. Cochrane Database Syst Rev 2003:CD003231.Shelley M.D., Court J.B., Kynaston H. et al. Intravesical bacillus Calmette-Guerin versus mitomycin C for Ta and T1 bladder cancer. Cochrane Database Syst Rev 2003:CD003231.5. Huncharek M., Kupelnick B. The influence of intravesical therapy on progression of superficial transitional cell carcinoma of the bladder: a metaanalytic comparison of chemotherapy versus bacilli Calmette-Guerin immunotherapy. Am J Clin Oncol 2004;27:522–8.Huncharek M., Kupelnick B. The influence of intravesical therapy on progression of superficial transitional cell carcinoma of the bladder: a metaanalytic comparison of chemotherapy versus bacilli Calmette-Guerin immunotherapy. Am J Clin Oncol 2004;27:522–8.6. Cookson M.S., Herr H.W., Zhang Z.F. et al. The treated natural history of high risk superficial bladder cancer: 15-year outcome. J Urol 1997;158:62–7.Cookson M.S., Herr H.W., Zhang Z.F. et al. The treated natural history of high risk superficial bladder cancer: 15-year outcome. J Urol 1997;158:62–7.7. Shahin O., Thalmann G.N., Rentsch C. et al. A retrospective analysis of 153 patients treated with or without intravesical bacillus Calmette-Guerin for primary stage T1 grade 3 bladder cancer: recurrence, progression and survival. J Urol 2003;169:96–100.Shahin O., Thalmann G.N., Rentsch C. et al. A retrospective analysis of 153 patients treated with or without intravesical bacillus Calmette-Guerin for primary stage T1 grade 3 bladder cancer: recurrence, progression and survival. J Urol 2003;169:96–100.8. Studer U.E. Radical cystectomy—often too late? Yes, but … Eur Urol 2006;50:1129–38.Studer U.E. Radical cystectomy—often too late? Yes, but … Eur Urol 2006;50:1129–38.9. Herr H.W., Sogani P.C. Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? J Urol 2001;166:1296–9.Herr H.W., Sogani P.C. Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? J Urol 2001;166:1296–9.10. Chang B.S., Kim H.L., Yang X.J, Steinberg G.D. Correlation between biopsy and radical cystectomy in assessing grade and depth of invasion in bladder urothelial carcinoma. Urology 2001;57:1063–7.Chang B.S., Kim H.L., Yang X.J, Steinberg G.D. Correlation between biopsy and radical cystectomy in assessing grade and depth of invasion in bladder urothelial carcinoma. Urology 2001;57:1063–7.11. Van Der Meijden A., Sylvester R., Collette L. et al. The role and impact of pathology review on stage and grade assessment of stages Ta and T1 bladder tumors: a combined analysis of 5 European Organization for Research and Treatment of Cancer Trials. J Urol 2000;164:1533–7.Van Der Meijden A., Sylvester R., Collette L. et al. The role and impact of pathology review on stage and grade assessment of stages Ta and T1 bladder tumors: a combined analysis of 5 European Organization for Research and Treatment of Cancer Trials. J Urol 2000;164:1533–7.12. Shariat S.F., Palapattu G.S., Karakiewicz P.I. et al. Discrepancy between clinical and pathologic stage: impact on prognosis after radical cystectomy. Eur Urol 2007;51:137–51.Shariat S.F., Palapattu G.S., Karakiewicz P.I. et al. Discrepancy between clinical and pathologic stage: impact on prognosis after radical cystectomy. Eur Urol 2007;51:137–51.13. Gupta A., Lotan Y., Bastian P.J. et al. Outcomes of Patients with Clinical T1 Grade 3 Urothelial Cell Bladder Carcinoma Treated with Radical Cystectomy. Urology 2008; 71(2):302−7.Gupta A., Lotan Y., Bastian P.J. et al. Outcomes of Patients with Clinical T1 Grade 3 Urothelial Cell Bladder Carcinoma Treated with Radical Cystectomy. Urology 2008; 71(2):302−7.14. Cheng L., Neumann R.M., Weaver A.L. et al. Grading and staging of bladder carcinoma in transurethral resection specimens: correlation with 105 matched cystectomy specimens. Am J Clin Pathol 2000;113:275–9.Cheng L., Neumann R.M., Weaver A.L. et al. Grading and staging of bladder carcinoma in transurethral resection specimens: correlation with 105 matched cystectomy specimens. Am J Clin Pathol 2000;113:275–9.15. Masood S., Sriprasad S., Palmer J.H. et al. T1G3 bladder cancer:indications for early cystectomy. Int Urol Nephrol 2004;36:41–4.Masood S., Sriprasad S., Palmer J.H. et al. T1G3 bladder cancer:indications for early cystectomy. Int Urol Nephrol 2004;36:41–4.16. Ficarra V., Dalpiaz O., Alrabi N. et al. Correlation between clinical and pathological staging in a series of radical cystectomies for bladder carcinoma. BJU Int 2005;95:786–90.Ficarra V., Dalpiaz O., Alrabi N. et al. Correlation between clinical and pathological staging in a series of radical cystectomies for bladder carcinoma. BJU Int 2005;95:786–90.17. Wiesner C., Pfitzenmaier J., Faldum A. et al. Lymph node metastases in non-muscle invasive bladder cancer are correlated with the number of transurethral resections and tumour upstaging at radical cystectomy. BJU Int 2005;95:301–5.Wiesner C., Pfitzenmaier J., Faldum A. et al. Lymph node metastases in non-muscle invasive bladder cancer are correlated with the number of transurethral resections and tumour upstaging at radical cystectomy. BJU Int 2005;95:301–5.18. Thalmann G.N., Markwalder R., Shahin O. et al. Primary T1G3 bladder cancer: organ preserving approach or immediate cystectomy? J Urol 2004; 172:70–5.Thalmann G.N., Markwalder R., Shahin O. et al. Primary T1G3 bladder cancer: organ preserving approach or immediate cystectomy? J Urol 2004; 172:70–5.19. Herr HW. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 1999;162:74–6.Herr HW. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 1999;162:74–6.20. Lee C.T., Madii R., Daignault S. et al. Cystectomy delay more than 3 months from initial bladder cancer diagnosis results in decreased disease specific and overall survival. J Urol 2006;175:1262–7.Lee C.T., Madii R., Daignault S. et al. Cystectomy delay more than 3 months from initial bladder cancer diagnosis results in decreased disease specific and overall survival. J Urol 2006;175:1262–7.21. Sanchez-Ortiz R.F., Huang W.C., Mick R. et al. An interval longer than 12 weeks between the diagnosis of muscle invasion and cystectomy is associated with worse outcome in bladder carcinoma. J Urol 2003; 169:110–5.Sanchez-Ortiz R.F., Huang W.C., Mick R. et al. An interval longer than 12 weeks between the diagnosis of muscle invasion and cystectomy is associated with worse outcome in bladder carcinoma. J Urol 2003; 169:110–5.22. Orsola A., Trias I., Raventos C.X. et al. Initial high-grade T1 urothelial cell carcinoma: feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG-treated and BCGnon-treated patients. Eur Urol 2005; 48:231–8.Orsola A., Trias I., Raventos C.X. et al. Initial high-grade T1 urothelial cell carcinoma: feasibility and prognostic significance of lamina propria invasion microstaging (T1a/b/c) in BCG-treated and BCGnon-treated patients. Eur Urol 2005; 48:231–8.23. Sylvester R.J., van der Meijden A.P., Oosterlinck W. et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006; 49:466–5.Sylvester R.J., van der Meijden A.P., Oosterlinck W. et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 2006; 49:466–5.24. Huguet J., Crego M., Sabate S. et al. Cystectomy in patients with high risk superficial bladder tumors who fail intravesical BCG therapy: pre-cystectomy prostate involvement as a prognostic factor. Eur Urol 2005;48: 53–9.Huguet J., Crego M., Sabate S. et al. Cystectomy in patients with high risk superficial bladder tumors who fail intravesical BCG therapy: pre-cystectomy prostate involvement as a prognostic factor. Eur Urol 2005;48: 53–9.25. Raj G.V., Herr H., Serio A.M. et al. Treatment paradigm shift may improve survival of patients with high risk superficial bladder cancer. J Urol 2007;177:1283–6.Raj G.V., Herr H., Serio A.M. et al. Treatment paradigm shift may improve survival of patients with high risk superficial bladder cancer. J Urol 2007;177:1283–6.