T1G3 방광암에서 경요도절제술 및 방광 내 BCG 주입요법 후 재발 및 진행의 임상양상

Abstract

PURPOSE: T1G3 bladder tumor has an incidence ranging from 6 to 23% of all superficial bladder tumors, a recurrence rate of 50 to 74%, and a rate of up to 50% for progression to invasive cancer after transurethral resection (TUR) followed by intravesical BCG instillation. We evaluated the recurrence and progression rates after TUR followed by BCG intravesical instillation.

MATERIALS AND METHODS: We retrospectively reviewed the records of 30 patients with T1G3 transitional cell carcinoma (TCCa); a group consisting of 14 papillary, 14 non-papillary and 2 mixed TCCa. We evaluated the tumor recurrence and progression rates in relation with the patients' age, tumor multiplicity and configuration. Mean patients' age was 63.2 years and mean follow-up duration was 32.2 months. All patients received TUR and BCG intravesical instillation.

RESULTS: Eleven cases (36.7%) had recurrence after a mean interval of 8.3 months, and 6 cases (20%) had progression after a mean interval of 10.2 months. The mean age appears to be a predictive factor of tumor recurrence, but not progression. All cases of non-papillary TCCa progressed to invasive bladder cancer. Two-year cumulative recurrence-free survival was 66.7% and progression-free survival was 83.3%.

CONCLUSIONS: Our study demonstrated the high recurrence rate and progression potential of T1G3 bladder tumor. In cases of tumor recurrence during the follow-up period in elderly patients and in cases of reported non-papillary TCCa, close observation is recommended and early cystectomy should be considered.