Repeated Surgery May Benefit Patients with Stage I Bladder Cancer
Among patients with stage I bladder cancer, repeated transurethral resection may improve patient outcomes. These results were published in The Journal of Urology .
Bladder cancer is a common cancer; approximately 55,000 new cases are diagnosed in the U.S. each year. Stage I bladder cancer refers to cancer that has spread to the connective tissue just beneath the inner lining of the bladder, but does not involve the bladder muscle.
Patients with stage I bladder cancer are often treated with surgical removal of the cancer and adjuvant therapy to decrease the risk of cancer recurrence or progression to more invasive disease. Adjuvant therapy often involves intravesical therapy (placement of the drug directly into the bladder) with mitomycin or Bacille Calmette-Guérin (BCG). Surgery may involve transurethral resection (removal of the tumor using an instrument passed through the urethra), or removal of all or part of the bladder.
While this therapy is beneficial, recurrences are common. In an attempt to reduce the risk of recurrence, researchers in Turkey evaluated the effect of repeated transurethral resection.
The study involved 148 patients with newly diagnosed stage I bladder cancer. Patients were randomly assigned to treatment with a single transurethral resection followed by intravesical mitomycin, or a series of two transurethral resections followed by intravesical mitomycin. In patients receiving repeated transurethral resections, the procedures were performed two to six weeks apart. Patients were followed for an average of two-and-a-half years.
26% of patients who received repeated transurethral resection experienced a cancer recurrence, compared to 63% of patients who received only a single transurethral resection.
The benefit of repeated transurethral resection was most apparent for patients with high-grade tumors (grade 2 or grade 3).
Overall survival was similar in the two groups; overall survival was 92% in patients treated with repeated transurethral resections and 90% in patients treated with a single transurethral resection.
For patients with high-grade T1 bladder tumors treated surgically with transurethral resection, a second round of surgery may reduce the risk of cancer recurrence.
Bladder cancer is a common cancer; approximately 55,000 new cases are diagnosed in the U.S. each year. Stage I bladder cancer refers to cancer that has spread to the connective tissue just beneath the inner lining of the bladder, but does not involve the bladder muscle.
Patients with stage I bladder cancer are often treated with surgical removal of the cancer and adjuvant therapy to decrease the risk of cancer recurrence or progression to more invasive disease. Adjuvant therapy often involves intravesical therapy (placement of the drug directly into the bladder) with mitomycin or Bacille Calmette-Guérin (BCG). Surgery may involve transurethral resection (removal of the tumor using an instrument passed through the urethra), or removal of all or part of the bladder.
While this therapy is beneficial, recurrences are common. In an attempt to reduce the risk of recurrence, researchers in Turkey evaluated the effect of repeated transurethral resection.
The study involved 148 patients with newly diagnosed stage I bladder cancer. Patients were randomly assigned to treatment with a single transurethral resection followed by intravesical mitomycin, or a series of two transurethral resections followed by intravesical mitomycin. In patients receiving repeated transurethral resections, the procedures were performed two to six weeks apart. Patients were followed for an average of two-and-a-half years.
26% of patients who received repeated transurethral resection experienced a cancer recurrence, compared to 63% of patients who received only a single transurethral resection.
The benefit of repeated transurethral resection was most apparent for patients with high-grade tumors (grade 2 or grade 3).
Overall survival was similar in the two groups; overall survival was 92% in patients treated with repeated transurethral resections and 90% in patients treated with a single transurethral resection.
For patients with high-grade T1 bladder tumors treated surgically with transurethral resection, a second round of surgery may reduce the risk of cancer recurrence.
posted by TM at 7:09 AM
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