Yüzeyel mesane tümörlerinin tedavisinde intravezikal BCG uygulamasının sonuçları
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Date
2005-05-23
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Uludağ Üniversitesi
Abstract
Bu çalışmada, orta ve yüksek nüks riski taşıyan yüzeyel mesane tümörlü olgulara uygulanan intravezikal Bacillus Calmette-Guerin (BCG) tedavisinin etkinliğinin değerlendirilmesi amaçlandı. 1992-2003 tarihleri arasında değişici epitel hücreli yüzeyel mesane tümörlü olgulara transüretral rezeksiyon-mesane tümörü (TUR-MT) uygulandı. TUR-MT’den 3 hafta sonra 55 olgunun 28 tanesine 6 hafta süreyle haftada 1 kez intravezikal 81 mg Pasteur BCG verilirken, 27’sine 6 haftalık tedaviyi takiben ayda 1 kez olmak üzere toplam 6 aylık tedavi uygulandı. Nüks saptanan olgulara TUR-MT yapılıp tümörün grade’i, evresi, progresyonu ve nüks süresi kaydedildi. Ortalama 36.42±3.16 ay (12-126 ay) süreyle takip edilen 55 hastadan 15’inde (% 27) nüks gözlenmiştir. Nüks gözlenen 15 hastadan 2’sinde (% 13) histopatolojik olarak tümörün grade ve evresinde artış izlenmiştir. Orta ve yüksek nüks riski taşıyan yüzeyel mesane tümörlerinde, TUR-MT sonrası intravezikal BCG immünoterapisi tümör nüks ve progresyonunu önlemede oldukça etkili bir tedavi seçeneğidir.
In this study, we aimed to evaluate the efficacy of Bacillus Calmette-Guerin (BCG) therapy administered intravesically in patients with superficial bladder tumors carrying moderate to high risk of recurrence. Fifty five patients undergoing transurethral resection of bladder tumors (TUR-BT) for the treatment of superficial transitional cell bladder tumor between 1992 and 2003 were included in the study. Three weeks after the resection, the patients received 81 mg of Pasteur BCG intravesically once a week for 6 weeks. In 27 of the patients, this therapy was continued as once a month for 6 months following the 6 weeks treatment period. TUR-BT was performed in patients who were determined to have recurrence of the tumor and, grade, stage and progression of the tumor and the time period of the recurrences were recorded. Recurrences were observed in 15 (27%) of 55 patients who have been followed up for 36.42±3.16 months in average (12126 months). In 2 (13%) of 15 patients having recurrences, there was an increase in the grade as well as stage of the tumor histopathologically. Intravesical BCG immunotherapy applied after TUR-BT is an effective therapeutic option to prevent recurrence and progression of the superficial bladder tumors carrying moderate and high risk of recurrence.
In this study, we aimed to evaluate the efficacy of Bacillus Calmette-Guerin (BCG) therapy administered intravesically in patients with superficial bladder tumors carrying moderate to high risk of recurrence. Fifty five patients undergoing transurethral resection of bladder tumors (TUR-BT) for the treatment of superficial transitional cell bladder tumor between 1992 and 2003 were included in the study. Three weeks after the resection, the patients received 81 mg of Pasteur BCG intravesically once a week for 6 weeks. In 27 of the patients, this therapy was continued as once a month for 6 months following the 6 weeks treatment period. TUR-BT was performed in patients who were determined to have recurrence of the tumor and, grade, stage and progression of the tumor and the time period of the recurrences were recorded. Recurrences were observed in 15 (27%) of 55 patients who have been followed up for 36.42±3.16 months in average (12126 months). In 2 (13%) of 15 patients having recurrences, there was an increase in the grade as well as stage of the tumor histopathologically. Intravesical BCG immunotherapy applied after TUR-BT is an effective therapeutic option to prevent recurrence and progression of the superficial bladder tumors carrying moderate and high risk of recurrence.
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Keywords
Mesane tümörleri, İntravezikal BCG uygulaması, Hastalık progresyonu, Nüks, Intravesical BCG administration, Bladder neoplasms, Disease progression, Recurrence
Citation
Çalışkan, Z. vd. (2005). ''Yüzeyel mesane tümörlerinin tedavisinde intravezikal BCG uygulamasının sonuçları''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 31(1), 31-34.