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5-aminolaevulinic acid-induced fluorescence cystoscopy during transurethral resection reduces the risk of recurrence in stage Ta/T1 bladder cancer
被引:104
作者:
Babjuk, M
[1
]
Soukup, V
[1
]
Petrík, R
[1
]
Jirsa, M
[1
]
Dvorácek, J
[1
]
机构:
[1] Charles Univ Prague, Fac Med 1, Gen Teaching Hosp, Dept Urol,Postgrad Inst, Prague, Czech Republic
关键词:
Ta/T1 bladder cancer;
recurrence-free interval;
fluorescence cystoscopy;
5-aminolaevulinic acid;
transurethral resection;
D O I:
10.1111/j.1464-410X.2004.05715.x
中图分类号:
R5 [内科学];
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号:
1002 ;
100201 ;
摘要:
OBJECTIVE To assess the influence of 5-aminolaevulinic acid-induced fluorescence cystoscopy (FC) during transurethral resection (TUR) on the recurrence rate and the length of tumour-free interval in stage Ta/T1 transitional cell carcinoma (TCC) of the urinary bladder. PATIENTS AND METHODS In all, 122 patients with primary or recurrent stage Ta/T1 bladder TCC treated with TUR were enrolled in a prospective randomized study. In group A the TUR was performed with standard white-light endoscopy, and in group B with FC. The patients were followed using standard cystoscopyand urinary cytology. The recurrence-free interval was evaluated in whole groups, for single and multiple, and for primary and recurrent tumours separately. RESULTS At the time of the first cystoscopy (10-15 weeks after TUR) tumour recurrence was detected in 23 of 62 patients (37%) in group A, but only in five of 60 patients (8%) in group B. The recurrence-free survival rates in group A were 39% and 28% after 12 and 24 months, compared to 66% and 40% respectively in group B (P=0.008, log-rank test). In separate analyses, the recurrence-free survival rates were significantly higher using FC in multiple (P= 0.001) and in recurrent (P= 0.02) tumours. In solitary and primary tumours the median time to recurrence was also longer in group B, but the difference was not statistically significant. CONCLUSION 5-aminolaevulinic acid-induced FC during TUR reduces the recurrence rate in stage Ta/T1 bladder TCC. The most significant benefit is in patients with multiple and recurrent tumours.
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页码:798 / 802
页数:5
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