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Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi

Year 2018, Volume: 8 Issue: 3, 190 - 193, 01.12.2018

Abstract

Amaç: Dünyada en sık görülen kanserler arasında dokuzuncu sırada yer alan mesane kanserleri, üriner sistemin en sık görülen maligniteleridir. 60 yaşın üzerinde ve erkeklerde daha sık görülürler.
En sık görülen belirtisi hematüridir. En sık görülen histopatolojik tipi ürotelyal hücreli karsinomlardır. Oldukça yüksek rekürrens ve
invazyon oranlarına sahiptirler. Mesane kanseri nedeniyle transüretral rezeksiyon (TURM) yapılan hastalar ilk iki yıl boyunca en az
üç-dört ayda bir, sonraki üç yıl boyunca her altı ayda bir, daha sonra yılda bir defa klinik/sistoskopik olarak takip edilirler. Çalışmanın
amacı, mesane tümörü tanısıyla TURM uygulanan vakaları ve bu
vakaların nüks materyallerindeki re-TUR sonuçlarını invazyon ve
histolojik grade açısından karşılaştırmalı olarak değerlendirmek,
sonuçları literatürle paylaşmak, hastaların prognozunun belirlenmesine, klinik takibi ve tedavisine katkı sağlamaktır.
Materyal ve Metot: Çalışmada üniversitesimizin patoloji arşivi kullanıldı. Mesane ürotelyal karsinom tanısı alan vakalar çalışmaya dahil
edildi. 2013–2018 tarihleri arasında mesane tümörü tanısıyla TURM
yapılan 177 olgu incelendi. Bu olguların parafin bloklarından alınan
kesitler Hematoksilen-Eozin boyamayla değerlendirildi. İlk doku teşhisi ile re-TUR sonuçları karşılaştırıldı.
Bulgular: Hastaların 153’ü erkek, 24’ü kadındı. Histopatolojik olarak 103 olguda yüksek dereceli, 74 olguda düşük dereceli ürotelyal
karsinom mevcuttu. 66 vakada noninvaziv ürotelyal karsinom mevcuttu. 102 vakada lamina propria invazyonu, 9 vakada muscularis
propria invazyonu saptandı. 46 (%26) vakada nüks olduğu saptandı. Tümör histolojik grade’i yüksek olan vakalarda ve invaziv vakalarda nüks oranları istatistiksel olarak anlamlı derecede yüksekti.
Nüks eden 11 düşük grade’li vakanın 3 (%27,2) tanesinde rekürrens materyallerinde yüksek grade’li tümör saptandı. Nüks eden 11
noninvaziv vakanın 2 (%18,2)’sinde invazyon saptandı.
Sonuç: Mesane TURM ve re-TUR sonuçları literatürle paylaşıldı.
İlk doku teşhisi ile nüks materyalinde invazyon varlığı ve histolojik
grade değişiklikleri mevcutsa, hastaların tedavi ve takibinin yeniden
planlanması gerektiği vurgulandı.

References

  • 1. Ploeg M, Aben KK, Kiemeney LA. The present and future burden of urinary bladder cancer in the world. World J. Urol. 2009; 27: 289–93.
  • 2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013; 63:11–30.
  • 3. Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017; 71: 96–108.
  • 4. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011; 61: 69–90.
  • 5. Herr HW, Donat SM. Quality control in transurethral resection of bladder tumours. BJU Int. 2008; 102: 1242-6.
  • 6. Kaufman DS, Shipley WU, Feldman AS. 2009. Bladder cancer. Lancet. 2009; 374: 239-49.
  • 7. Wallace DMA, Bryan RT, Dunn JA, Begum G, Bathers S. 2002. Delay and survival in bladder cancer. BJU Int. 2002; 89: 868-78.
  • 8. Yun SJ, Kim WJ. Role of the epithelial-mesenchymal transition in bladder cancer: From prognosis to therapeutic target. Korean J Urol. 2013; 54: 645–50.
  • 9. Montie JE, Abrahams NA, Bahnson RR, Eisenberger MA, El-Galley R, Herr HW, et al. Bladder cancer. Clinical guidelines in oncology. J Natl Compr Canc Netw. 2006; 4: 984–1014.
  • 10. Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Comperat EM, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017;71: 447-61.
  • 11. Black PC. Fine-tuning risk stratification for non-muscle-invasive bladder cancer. Eur Urol. 2016; 69: 70–1.
  • 12. Bertz S, Otto W, Denzinger S, Wieland WF, Burger M, Stohr R, et al. Combination of CK20 and Ki-67 immunostaining analysis predicts recurrence, progression, and cancer-specific survival in pT1 urothelial bladder cancer. Eur Urol. 2014; 65: 218-226.
  • 13. Mostafid H, Brausi M. Measuring and improving the quality of transurethral resection for bladder tumour (TURBT). BJU Int. 2012;109: 1579-82.
  • 14. Kim JK, Moon KC, Jeong CW, Kwak C, Kim HH, Ku JH. Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) After Initial TUR-BT: Comparative Analyses with Non-invasive Low-Grade Papillary Urothelial Carcinoma (LGPUC). J.Cancer. 2017; 8: 2885-91.
  • 15. Van Rhijn BW, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, et al. 2009. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur. Urol. 2009; 56:430-42.
  • 16. Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006; 49: 466–75.
  • 17. Holmang S, Johansson SL. Stage TA-T1 bladder cancer: the relationship between findings at first followup cystoscopy and subsequent recurrence and progression. J Urol 2002; 167: 1634-7.
  • 18. Kamat AM, Bağcıoğlu M, Huri E. What is new in non-muscle-invasive bladder cancer in 2016? Turk J Urol. 2017; 43: 9-13.

Retrospective Analysis of 177 Cases Treated with Transurethral Resection

Year 2018, Volume: 8 Issue: 3, 190 - 193, 01.12.2018

Abstract

Aim: Bladder cancers are the ninth most common malignancies in
the world. These are the most common malignancies of the urinary
tract. The most common histological type of this cancer is urothelial cell carcinoma. It has very high rates of recurrence and invasion. The aim of this study is to evaluate the results of bladder TUR
and re-TUR cases in terms of invasion and histological grade, to
share the results with the literature, to determine the prognosis of
patients and to contribute to the clinical follow-up and treatment.
Material and Method: Pathology archive of Erzincan Binali
Yıldırım University was used in this study. Cases with urothelial
carcinoma of the bladder were included in the study. A total of
177 cases who underwent bladder TUR between 2013–2018 were
examined. Sections from the paraffin blocks of these cases were
evaluated with Hematoxylin-Eosin staining. Re-TUR results were
compared with the first TUR diagnosis.
Results: 153 of the patients were male and 24 were female. In 103
cases, the tumor was high-grade and 74 patients had low-grade tumor. Sixty-six cases had non-invasive urothelial carcinoma. Lamina
propria invasion was detected in 102 cases and muscularis propria
invasion in 9 cases. 46 (26%) cases had a recurrence. Recurrence
rates were significantly higher in the cases with high-grade tumor
and in the invasive cases. 3 (27.2%) of the recurrent 11 low-grade
cases had a high-grade tumor in the recurrence material. The invasion was detected in 2 (18.2%) of 11 noninvasive cases.
Conclusion: Bladder TUR and re-TUR results were shared with
the literature. It was emphasized that if there is invasion and histological grade changes in the recurrence and the first TUR diagnosis, treatment and follow-up of patients should be re-planned.

References

  • 1. Ploeg M, Aben KK, Kiemeney LA. The present and future burden of urinary bladder cancer in the world. World J. Urol. 2009; 27: 289–93.
  • 2. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013; 63:11–30.
  • 3. Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017; 71: 96–108.
  • 4. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011; 61: 69–90.
  • 5. Herr HW, Donat SM. Quality control in transurethral resection of bladder tumours. BJU Int. 2008; 102: 1242-6.
  • 6. Kaufman DS, Shipley WU, Feldman AS. 2009. Bladder cancer. Lancet. 2009; 374: 239-49.
  • 7. Wallace DMA, Bryan RT, Dunn JA, Begum G, Bathers S. 2002. Delay and survival in bladder cancer. BJU Int. 2002; 89: 868-78.
  • 8. Yun SJ, Kim WJ. Role of the epithelial-mesenchymal transition in bladder cancer: From prognosis to therapeutic target. Korean J Urol. 2013; 54: 645–50.
  • 9. Montie JE, Abrahams NA, Bahnson RR, Eisenberger MA, El-Galley R, Herr HW, et al. Bladder cancer. Clinical guidelines in oncology. J Natl Compr Canc Netw. 2006; 4: 984–1014.
  • 10. Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Comperat EM, et al. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017;71: 447-61.
  • 11. Black PC. Fine-tuning risk stratification for non-muscle-invasive bladder cancer. Eur Urol. 2016; 69: 70–1.
  • 12. Bertz S, Otto W, Denzinger S, Wieland WF, Burger M, Stohr R, et al. Combination of CK20 and Ki-67 immunostaining analysis predicts recurrence, progression, and cancer-specific survival in pT1 urothelial bladder cancer. Eur Urol. 2014; 65: 218-226.
  • 13. Mostafid H, Brausi M. Measuring and improving the quality of transurethral resection for bladder tumour (TURBT). BJU Int. 2012;109: 1579-82.
  • 14. Kim JK, Moon KC, Jeong CW, Kwak C, Kim HH, Ku JH. Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) After Initial TUR-BT: Comparative Analyses with Non-invasive Low-Grade Papillary Urothelial Carcinoma (LGPUC). J.Cancer. 2017; 8: 2885-91.
  • 15. Van Rhijn BW, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, et al. 2009. Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur. Urol. 2009; 56:430-42.
  • 16. Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, et al. Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006; 49: 466–75.
  • 17. Holmang S, Johansson SL. Stage TA-T1 bladder cancer: the relationship between findings at first followup cystoscopy and subsequent recurrence and progression. J Urol 2002; 167: 1634-7.
  • 18. Kamat AM, Bağcıoğlu M, Huri E. What is new in non-muscle-invasive bladder cancer in 2016? Turk J Urol. 2017; 43: 9-13.
There are 18 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Erkan Hirik This is me

Mecdi Gürhan Balcı This is me

Publication Date December 1, 2018
Published in Issue Year 2018 Volume: 8 Issue: 3

Cite

APA Hirik, E., & Balcı, M. G. (2018). Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi. Kafkas Journal of Medical Sciences, 8(3), 190-193.
AMA Hirik E, Balcı MG. Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi. KAFKAS TIP BİL DERG. December 2018;8(3):190-193.
Chicago Hirik, Erkan, and Mecdi Gürhan Balcı. “Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi”. Kafkas Journal of Medical Sciences 8, no. 3 (December 2018): 190-93.
EndNote Hirik E, Balcı MG (December 1, 2018) Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi. Kafkas Journal of Medical Sciences 8 3 190–193.
IEEE E. Hirik and M. G. Balcı, “Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi”, KAFKAS TIP BİL DERG, vol. 8, no. 3, pp. 190–193, 2018.
ISNAD Hirik, Erkan - Balcı, Mecdi Gürhan. “Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi”. Kafkas Journal of Medical Sciences 8/3 (December 2018), 190-193.
JAMA Hirik E, Balcı MG. Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi. KAFKAS TIP BİL DERG. 2018;8:190–193.
MLA Hirik, Erkan and Mecdi Gürhan Balcı. “Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi”. Kafkas Journal of Medical Sciences, vol. 8, no. 3, 2018, pp. 190-3.
Vancouver Hirik E, Balcı MG. Mesane Kanseri Nedeniyle Transüretral Rezeksiyon Yapılan 177 Olgunun Retrospektif Analizi. KAFKAS TIP BİL DERG. 2018;8(3):190-3.