文献詳細
特集 筋層非浸潤性膀胱癌に関する最近の話題
文献概要
要旨 近年,筋層非浸潤性膀胱癌に対して正確な診断を期すために2nd TURBTを施行するようガイドラインでも推奨されている。2nd TURBTは通常,T1やhigh grade TaなどのT2以上の病変の除外が完全にできないような症例に対して行われ,腫瘍の残存率は28.5~52.0%,upstageした率は4.0~9.6%とされている。また診断的意義のみでなく,2nd TURBTにより再発率・進展率の低下といった治療的意義も示唆されている。しかしあくまでも局所評価であること,また初回のTURBTの程度により成績や意味付けが異なることから,結果の解釈には注意が必要である。
参考文献
1)日本泌尿器科学会(編):膀胱癌診療ガイドライン.医学図書出版,東京,2009
2)Babjuk M, Oosterlinck W, Sylvester R, et al:EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 54:303-314, 2008
3)Hall MC, Chang SS, Dalbagni G, et al:Guideline for the management of nonmuscle invasive bladder cancer(Stages Ta, T1, and Tis):2007 update. J Urol 178:2314-2330, 2007
4)Klän R, Loy V and Huland H:Residual tumor discovered in routine second transurethral resection in patients with stage T1 transitional cell carcinoma of the bladder. J Urol 146:316-318, 1991
5)Herr HW:The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol 162:74-76, 1999
6)Brauers A, Buettner R and Jakse G:Second resection and prognosis of primary high risk superficial bladder cancer:is cystectomy often too early? J Urol 165:808-810, 2001
7)Dalbagni G, Herr HW and Reuter VE:Impact of a second transurethral resection on the staging of T1 bladder cancer. Urology 60:822-825, 2002
8)Schips L, Augustin H, Zigeuner RE, et al:Is repeated transurethral resection justified in patients with newly diagnosed superficial bladder cancer? Urology 59:220-223, 2002
9)Grimm MO, Steinhoff C, Simon X, et al:Effect of routine repeat transurethral resection for superficial bladder cancer:a long-term observational study. J Urol 170:433-437, 2003
10)Divrik T, Yildirim U, Eroğlu AS, et al:Is a second transurethral resection necessary for newly diagnosed pT1 bladder cancer? J Urol 175:1258-1261, 2006
11)Divrik RT, Yildirim U, Zorlu F, et al:The effect of repeat transurethral resection on recurrence and progression rates in patients with T1 tumors of the bladder who received intravesical mitomycin:a prospective, randomized clinical trial. J Urol 175:1641-1644, 2006
12)Schwaibold HE, Sivalingam S, May F, et al:The value of a second transurethral resection for T1 bladder cancer. BJU Int 97:1199-1201, 2006
13)Herr HW, Donat SM and Dalbagni G:Can restaging transurethral resection of T1 bladder cancer select patients for immediate cystectomy? J Urol 177:75-79, 2007
14)Dwivedi US, Kumar A, Das SK, et al:Relook TURBT in superficial bladder cancer:its importance and its correlation with the tumor ploidy. Urol Oncol 27:514-519, 2009
15)Divrik RT, Sahin AF, Yildirim U, et al:Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pt1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival:a prospective randomised clinical trial. Eur Urol, 2010(in press)
16)Guevara A, Salmon L, Allory Y, et al:The role of tumor-free status in repeat resection before intravesical Bacillus Calmette-Guerin for high grade Ta, T1 and CIS bladder cancer. J Urol 183:2161-2164, 2010
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