RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法课件

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1、RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法BLADDER CANCER:TWO PATHWAYS OF PROGRESSIONNORMALUROTHELIUMTaTa9qDelRAST1T2-

2、4N+/M+9pDel(INK4A)(Presti et al, Ca Res 91; Cordon-Cardo et al, JNCI 92; Dalbagni et al, Lancet 93; Sarkis et al, JNCI 93; Cairns et al, Science 94; Orlow et al, JNCI 95; Li et al, Am J Path 96; Rabbani et al, JNCI 99; McShane et al, Ca Res 2000; Hernando et al, Int J Ca 2001; Sanchez et al, Ca Res,

3、 2002; Veltman et al Ca Res, 2003 )TisT1T2-4N+/M+TP53RB5qDel, 3pDel10qDel, 11pDel, 18qDel14qDelRadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法10 - 15% have positive nodes at cystectomyRadicalCystec

4、tomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Dutta, J Urol 166:490, 2001N=78Herr, HW J Urol 162:74, 1999A second TURBT required to identify extent of disease.RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Freeman et al, Cancer, 1995179 patients (71% with

5、T1 tumors)53% failed intravesical therapyUnderstaged lesions do significantly worseUnderstaged lesions WILL NOT respond to bladder sparing approachesRadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Dalbagni et al, UROLOGY 2002RadicalCystectomyAsPrimaryTherapyforT1G3BladderC

6、ancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Recurrence-free survivalCancer-specific survivalOrsola et al Eur Urol 48:231, 2005RadicalCystectomyAsPrimaryTherapyforT1G3B

7、ladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Cookson, J Urol 158:62, 1997Pansodoro, Urology 59:227, 2002Shahin, J Urol 169:96, 2003RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法Cookson J Urol 158:62, 1997People not treated by cystectomy continue to die of bladder cancer!RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法RadicalCystectomyAsPrimaryTherapyforT1G3BladderCancer根治性膀胱切除术对于T1G3膀胱癌的主要疗法MAJORITY