Ömer BAYRAK, Haluk ŞEN, Erkan SADİOĞLU, İlker SEÇKİNER, Sakıp ERTURHAN

Genç hastalarda invaziv olmayan mesane kanseri: Uzun dönem takip sonuçları

Amaç: Mesanenin transizyonel hücreli karsinomu 35 yaş altında nadir görülen bir hastalıktır. Çalışmamızda, genç yaştaki hastaların uzun dönem tedavi sonuçlarını ve takiplerini sunmayı amaçladık. Gereç ve Yöntem: Yaşları 11-35 arası değişen, mesane tümörü tanısı almış 20 hastanın verileri retrospektif olarak incelendi. Tüm hastalara post-operatif ilk 12 saat içinde intravezikal epirubicin veya mitomicin kemoterapisi uygulandı. Hastalara evrelerine göre uygun protokolde kontrol sistoskopisi yapıldı. Hastalar yılda bir kez bilgisayarlı tomografi ve Nükleer Matriks Proteini-22 testi ile takip edildi.Bulgular: Bir hastada mesane tümörünü taklit eden amiloidoz saptandı ve hasta çalışma dışı bırakıldı. Çalışma kapsamında değerlendirilen 9 erkek ve 10 kadın hastanın ortalama yaşı 25.1 yıl, ortalama takip süresi 67.4 ay olarak hesaplandı. Hastaların tamamında tek odakta tümör mevcut olup, ortalama tümör boyutu 2.55 santimetre olarak ölçüldü. TNM sınıflamasına göre 2 (%10.5) hastada benin papilloma, 15 (%78.9) hastada Ta patoloji, 2 (%10.5) hastada T1 patoloji rapor edildi. Patoloji sonucu T1 olarak rapor edilen 2 (%10.5) hastaya intravezikal Bacillus Calmette Guerin (BCG) tedavisi uygulandı. Altı haftalık BCG uygulaması sonrası relaps meydana gelen bu hastalara BCG tedavisi yeniden başlandı ve takiplerinde nüks görülmedi. NMP-22 testi sadece relapsı olan 2 hastada pozitif olarak saptandı. Ayrıca 35 yaş altındaki bu hastaların hiçbirinde progresyon da izlenmedi. Sonuçlar: Güncel literatürlerin ve mevcut çalışmamızın sonuçlarına göre; mesanenin transizyonel hücreli karsinomunun, genç hastalarda düşük dereceli ve uzun dönem takiplerde iyi prognozlu olduğu görülmektedir.

Non-invasive bladder cancer in younger patients: Results of long-term follow-up

Purpose: The transitional cell carcinoma of the bladder (TCCB) is a rare disease below 35 years old patients. In our study, we aimed to present the treatment results and long-term follow-up process of younger patients.Materials and Methods: A 20 patients aged between 11-35 years were reviewed retrospectively. Intravesical epirubicin or mitomycin was administered to all of the patients within the first 12 hours in the postoperative period. The patiens were followed-up with cystoscopies according to the protocol. Abdominal computed tomography and Nuclear Matrix Protein-22 bladder control tests were performed once a year.Results: Amyloidosis mimicked bladder tumor was detected in one patient and this patient was excluded from the study. The mean age of the 9 male and 10 female patients was calculated as 25.1 years and the mean duration of follow-up was calculated as 67.4 months. All of the patients had single tumoral focus and mean tumor size was calculated as 2.55 centimeters. According to the TNM classification, 2 (10.5%) patients were reported as benign papilloma, 15 (78.9%) patients as Ta, and 2 (10.5%) patients as T1. Intravesical Bacillus Calmette Guerin (BCG) was administered to 2 (10.5%) patients whose pathologies were recorded as T1. After sixth doses of intravesical BCG, relapses occurred in these 2 patients. Intravesical BCG therapy was started again, and no relapses were observed in subsequent follow-ups. NMP-22 test yielded positive results only in 2 (10.5%) patients with relapses. In addition, progression was not observed in any of patients below 35 years old. Conclucions: According to the related literature and the clinical results of the current study, TCCB appears as low grade in younger ages with better prognosis at long-term follow-up.

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