İleri Yaş Kas İnvaziv Olmayan Mesane Kanserli Hastalarda Rekürens ve Progresyon Gelişimine Etkilidir

Year 2020, Volume: 15 Issue: 3, 171 - 175, 27.10.2020

Göksel Bayar , Fatih Kılınç

https://doi.org/10.33719/yud.638579

Abstract

Amaç: Primer ve kas
invaziv olmayan mesane kanserli (KİOMK) hastalarda rekürens ve progresyona
yaşın etkisini incelemeyi amaçladık.

Gereç ve Yöntemler: Kliniğimizde
2005-2010 yılları arasında primer mesane tümörü nedeniyle transüretral mesane
tümörü rezeksiyonu (TUR-BT) uygulanan hastaların dosyaları geriye doğru
incelendi. İlk TUR-BT sonucu KİOMK olan ve mesane dışı tutulumu olmayan hastalar
çalışmaya dahil edildi. Hastalar yaş (60 yaşın altında, 60-70 yaş arası, 70
yaşın üstündekiler), cinsiyet, tümör boyutu (3 cm’nin altında ve üstünde);
tümör sayısı (1, 2-7 arası ve >7 olarak); evre (Ta ve T1) ve greydine (G1,
G2 ve G3) göre gruplandırıldı.

Bulgular: Çalışmaya
toplam 316 hasta dahil edildi. Çalışmaya alınan hastalardan 226’sında (%71,5)
rekürens ve 71’inde (%22,5) progresyon izlendi. Univariete analizde hastanın
yaşı (> 65), tümörün sayısı (>1), boyutu (>3 cm), evresi (T1) ve greydinin
(G3) rekürens ve progresyon gelişiminde etkili olduğu görülmüştür. Kaplan-Meier
analizinde yaş grupları arasında rekürense kadar geçen süre açısından anlamlı
bir fark olduğunu gördük (p= 0,001), yaş artıkça rekürens olasılığı artmakta ve
rekürense kadar geçen süre azalmaktadır. Progresyon analizinde de aynı şekilde
gruplar arasında anlamlı fark olduğunu ve yaşın artıkça progresyon riskinin
arttığını ve progresyona kadar geçen sürenin kısaldığını gördük (p= 0,004).

Sonuç: KİOMK hastalarda
yaş arttıkça, özellikle 70 yaşın üstünde, rekürens ve progresyon ihtimalinin
belirgin şekilde arttığını tespit ettik. 

Keywords

Mesane kanseri , kaz invaziv olmayan , ileri yaş , progresyon , rekürrens

The Advanced Age is Effective on Recurrence and Progression in Patients With Non-Muscle Invasive Bladder Cancer

Abstract

Objective: To evaluate the effect of age on recurrence and progression in patients with primary and non-muscle invasive bladder cancer (NMIBC).

Material and Methods: The records of patients who underwent transurethral bladder tumor resection (TUR-BT) for primary bladder tumor between 2005-2010 were retrospectively reviewed. Patients who had NMIBC after the first TUR-BT and without extra-bladder involvement were included in the study. The patients were grouped in terms of age (under 60 years, 60-70 years, over 70 years), sex, tumor size (below and above 3 cm); the number of tumors (between 1, 2-7 and> 7); stage (Ta and T1) and grade (G1, G2 and G3).

Results: A total of 316 patients were included in the study. Recurrence was seen in 226 (71.5%) and progression 71 patients (22.5%). Univariate analysis showed that age (> 70), tumor number (> 1), size (> 3 cm), stage (T1) and grade (G3) are effective in the development of recurrence and progression. Kaplan-Meier analysis showed that there was a significant difference between the age groups in terms of time to recurrence (p = 0.001), as age increased the probability of recurrence increased and time to recurrence decreased. There was a significant difference between the groups in the progression analysis and that the risk of progression increased with age and the time to progression decreased (p = 0.004).

Conclusions: We found that the probability of recurrence and progression was significantly increased with age, especially over 70 years of age, in patients with NMIBC. 

Keywords

Bladder cancer , non-muscle invazive , advanced age , progression , recurrence

References

• 1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013.
• 2. Burger M, Catto JW, Dalbagni G, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol 2013;63:234-41.
• 3. Sylvester RJ, van der Meijden AP, 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;49:466-77.
• 4. Millan-Rodriguez F, Chechile-Toniolo G, Salvador-Bayarri J, Palou J, Algaba F, Vicente-Rodriguez J. Primary superficial bladder cancer risk groups according to progression, mortality and recurrence. J Urol 2000;164:680-4.
• 5. Oeppen J, Vaupel JW. Demography. Broken limits to life expectancy. Science. 2002 10;296:1029-31.
• 6. Antunes YP, Bugano DD, Del Giglio A, Kaliks RA, Karnakis T, Pontes Lde B. Clinical features and overall survival among elderly cancer patients in a tertiary cancer center. Einstein (Sao Paulo). 2015;13:487-91.
• 7. Fernandez-Gomez J, Madero R, Solsona E, et al. Predicting nonmuscle invasive bladder cancer recurrence and progression in patients treated with bacillus Calmette-Guerin: the CUETO scoring model. J Urol. 2009;182:2195-203.
• 8. Calò B, Sanguedolce F, Fortunato F, et al. The impact of age on intravesical instillation of Bacille Calmette-Guerin treatment in patients with high-grade T1 bladder cancer. Medicine (Baltimore). 2019;98:16223.
• 9. Herr HW. Age and outcome of superficial bladder cancer treated with bacille Calmette-Guérin therapy. Urology. 2007;70:65-8.
• 10. Margel D, Alkhateeb SS, Finelli A, et al. Diminished efficacy of Bacille Calmette-Guérin among elderly patients with nonmuscle invasive bladder cancer. Urology 2011;78:848–54.
• 11. Oddens JR, Sylvester RJ, BrausiMA, et al. The effect of age on the efficacy of maintenance Bacillus Calmette-Guérin relative to maintenance epirubicin in patients with stage Ta T1 urothelial bladder cancer: results from EORTC genito-urinary group study 30911. Eur Urol 2014;66:694–701.
• 12. Lu M, Chen S, Zhou Q, Wang L, Peng T, Wang G. Predicting recurrence of nonmuscle-invasive bladder cancer (Ta-T1): A study based on 477 patients. Medicine (Baltimore). 2019;98:e16426.