Analysis of Intravesical Recurrence After Bladder-preserving Therapy for Muscle-invasive Bladder Cancer

作者：Onozawa Mizuki; Miyanaga Naoto; Hinotsu Shiro; Miyazaki Jun; Oikawa Takehiro; Kimura Tomokazu; Takaoka Ei ichiro; Kawai Koji; Shimazui Toru; Sakurai Hideyuki; Nishiyama Hiroyuki^*; Akaza Hideyuki

来源：Japanese Journal of Clinical Oncology, 2012, 42(9): 825-830.

DOI：10.1093/jjco/hys105

• drug therapy
• preservation
• radiation
• recurrence
• urinary bladder neoplasms

The aim of the present study was to analyze the pattern of recurrences after bladder-preserving therapy for muscle-invasive bladder cancer. %26lt;br%26gt;The subjects were 77 patients with T2-3N0M0 bladder cancer whose bladder was preserved by intra-arterial chemotherapy and radiation. The patterns of the first recurrences were retrospectively analyzed. %26lt;br%26gt;With a median follow-up of 38.5 months, 17 patients (22.1) experienced intravesical recurrence without metastasis, 14 (82.4) of which were cases of non-muscle-invasive bladder cancer recurrence and 3 (17.6) of which were muscle-invasive bladder cancer recurrences. Muscle-invasive bladder cancer recurred at the same site as the initial tumor site in all three cases, whereas non-muscle-invasive bladder cancer recurred at different sites in 64 of the patients in that group. The peak hazard of the non-muscle-invasive bladder cancer recurrence was observed at around a year after treatment. Recurrent non-muscle-invasive bladder cancer was of a significantly lower histological grade with lower Ki-67-labeling indices than the initial muscle-invasive bladder cancer. Twelve (85.7) of 14 patients with non-muscle-invasive bladder cancer recurrence achieved disease-free status. The multivariate analysis revealed that multiplicity, grade and tumor size were significantly correlated with the recurrence (P 0.0001, 0.0442 and 0.0412, respectively). %26lt;br%26gt;Most of the recurrences after bladder-preserving therapy were cases of non-muscle-invasive bladder cancer. The recurrence pattern and characteristics of the tumors did not differ from those of primary non-muscle-invasive bladder cancer. Patients with high-risk factors would be candidates for prophylactic intravesical therapy for non-muscle-invasive bladder cancer recurrence.

• 出版日期2012-9