Hastanemizde Mesane Tümörü Tanı, Tedavi ve Takip Sonuçlarımız

Öz

Amaç: Biz bu çalışmamızda Amasya Sabuncuoğlu Şerefettin Eğitim Araştırma Hastanesi üroloji kliniğinde son 5 yıl içerisinde mesane kanseri tanısı ile transüretral rezeksiyon (TUR) yapılan hastaların demografik özellikleri, patolojik değerlendirme sonuçları, prognoz ve progresyonlarını irdeleyerek sunmayı amaçladık Gereç ve yöntem: Hastanemizde Ocak 2016- Ocak 2022 tarihleri arasında mesane kanseri ön tanısı ile TUR yapılan ve patoloji sonucu mesane karsinomu çıkan; hastane sistemi taranarak verileri elde edilen 252 hasta retrospektif olarak değerlendirildi. Bulgular: Yaş ortalaması erkeklerde 58±4.3 yıl iken kadınlarda 65±2.4 yıl olarak saptandı. Ortalama takip süresi 31±5.2 ay idi. Tümör tipine bakıldığında ise %78’i papiller yapıda iken %15 solid ve %7’si mikst tipte idi. Patolojik verilere göre hastaların %92’sinde üretelyal karsinom %4’ünde skuamoz karsinom, %3’ünde adenokarsinom ve %1’inde nöroendokrin tümör olduğu saptandı. 252 hastanın 162’sinde intrakaviter tedavi uygulandığı bunların ise 145’i BCG ve 17’sinde Epirubisin kullanıldığı görüldü. Nüks olmayan hastaların %80’ninin intrakaviter tedavi aldığı, nüks olanların ise %40’ının intrakaviter tedavi aldığı görüldü Sonuç: Hastanemizde mesane tümörü tanısı ve tedavisinde altın standart olarak TUR kullanılmakta olup patolojik değerlendirme sonrası klavuzlara uygun olarak intrakaviter tedavi ve kontrol sistoskopileri yapılmaktadır.

Anahtar Kelimeler

• İntrakaviter tedavi
• Mesane tümörü
• Transüretral rezeksiyon

Bladder Tumor Diagnosis, Treatment and Follow-up Results in Our Hospital

Öz

Objectives: In this study, we aimed to present the demographic characteristics, pathological evaluation results, prognosis and progression of patients who underwent transurethral resection (TUR) with the diagnosis of bladder cancer in the urology clinic of Amasya Sabuncuoğlu Şerefettin Training and Research Hospital in the last 5 years. Materials and Methods: In our hospital, between January 2016 and January 2022, TUR was performed with a preliminary diagnosis of bladder cancer and bladder carcinoma was found as a result of pathology; 252 patients whose data were obtained by scanning the hospital system were evaluated retrospectively. Results: While the mean age was 58±4.3 years in males, it was 65±2.4 years in females. The mean follow-up period was 31±5.2 months. Looking at the tumor type, 78% were papillary, 15% were solid and 7% were mixed. According to pathological data, 92% of the patients had urethelial carcinoma, 4% had squamous carcinoma, 3% had adenocarcinoma, and 1% had neuroendocrine tumor. Intracavitary treatment was applied in 162 of 252 patients, 145 of them were using BCG and 17 of them were using Epirubicin. It was observed that 80% of non-relapsed patients received intracavitary treatment, and 40% of those with relapses received intracavitary treatment. Conclusion: In our hospital, TUR is used as the gold standard in the diagnosis and treatment of bladder tumor, and intracavitary treatment and control cystoscopies are performed in accordance with the guidelines after pathological evaluation.

Anahtar Kelimeler

• Bladder tumor
• İntracavitary treatment
• Transurethral resection

Kaynakça

1. 1. Bedük Y. Mesane Tümörleri. Anafarta K, Bedük Y, Arıkan N (editörler), Temel Üroloji, Güneş Kitabevi, Ankara, 2007. p.725-740.
2. 2. Tanagho EA, McAninch JW. Genel Üroloji. 17. Baskı. Mesane tümörü. Nobel Tıp Kitabevleri, 2009. p. 308-327.
3. 3. Ferlay J, Bray F, Forman D. Cancer Incidence and Mortality Worldwide: IARC CancerBase International Agency for Research on Cancer: Lyon, France. 2010;GLOBOCAN 2008 v. 1.2 No. 10.
4. 4. Herr HW, Donat SM. Quality control in transurethral resection of bladder tumours. BJU Int 2008;102:1242–6.
5. 5. Kaufman DS, Shipley WU, Feldman AS 2009. Bladder cancer. Lancet 2009;374:239–49.
6. 6. McDougal WS, Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology 10th Edition Review [Internet]. Elsevier Health Sciences; 2011
7. 7. Panagiotakis GI, Papadogianni D, Chatziioannou MN, et al. Association of human herpes, papilloma and polyoma virus families with bladder cancer. Tumor Biology. 2013;34:71–9
8. 8. Mostafid H, Brausi M. Measuring and improving the quality of transurethral resection for bladder tumour (TURBT). BJU Int. 2012; 109: 1579-82.

9. 9. Eble JN, Sauter, G., Epstein, J.I,Sesterhenn, I.A. Pathology and Genetics of Tumours of the Urinary System and Male Genital Organs. Lyon: IARC Press; 2004.
10. 10. Borhan A, Reeder JE, O’Connell MJ, et al: Grade progression and regression in recurrent urothelial cancer. J Urol, 169: 2106-9, 2003.
11. 11. Pruthi RS, Baldwin N, Bhalani V, et al: Conservative management of low risk superficial bladder tumours. J Urol, 179: 87-90, 2008.
12. 12. Shelley MD, Kynaston H, Court J, et al: A systematic review of intravesical bacillus Calmette-Guerin plus transurethral resection vs transurethral resection alone in Ta and T1 bladder cancer. BJU Int, 88(3): 209-16, 2001.
13. 13. Han RF, Pan JG. Can intravesical bacillus Calmette-Guerin reduce recurrence in patients with superficial bladder cancer? A meta-analysis of randomized trials. Urology, 67(6): 1216-23, 2006.