| ObjectiveTo investigate the efficacy and safety of transurethral resection of bladder tumors(TURBT)with gemcitabine and mitomycin bladder hyperperfusion in preventing the recurrence of non-muscle invasive bladder cancer(NMIBC),and provide more clinical diagnosis and treatment.Many choices and basis.MethodsA retrospective analysis of 119 patients with non-muscle invasive bladder cancer(NMIBC)admitted to the Cancer Hospital of Zhengzhou University from January 2014 to December 2018.All underwent pathological examination after transurethral resection of the bladder tumor(TURBT).The analysis was urinary transitional epithelial cell carcinoma and the pathological stage was non-muscle invasive carcinoma.The patients were divided into three groups according to different treatment methods after surgery.The gemcitabine(GEM)hot perfusion group was 42 patients in group A.1000mg of GEM was dissolved in 50ml of normal saline within 24 hours after surgery at normal temperature of the bladder,and 1 week after operation,GEM 2000mg dissolved in 1000ml of normal saline was used for bladder thermal infusion once a week for a total of 8 times,then used once per month for a total of 8 times;The mitomycin(MMC)hot perfusion group was 37 patients in group B.Within 24 hours after surgery,30mg of MMC was dissolved in 50ml of normal saline for bladder perfusion at room temperature.One week after operation,60mg of MMC dissolved in 1000ml of normal saline was used for bladder thermal infusion once a week for a total of 8 times,then used once per month for a total of 8 times;Gemcitabine(GEM)room temperature perfusion group was 40 cases in group C,GEM 1000mg dissolved in 50ml of normal saline within 24 hours after surgery at normal temperature of the bladder,the method was continued for bladder normal temperature perfusion after 1 week,the first 2 months,once a week,a total of 8 times,and the next 10 months,once a month,a total of 10 times.Comparative analysis of the three groups of patients recurred during follow-up Rate,progress rate and occurrence of adverse reactions.ResultsThe follow-up period was 12-36 months,with a median time of 20 months.The group A with group B and group C were divided according to the age,gender,and companionship of the patients,there were no statistically significant differences in related indicators such as disease and bladder tumor staging(p>0.05).The main adverse reactions were:bladder irritation(frequency,urgency,dysuria),hematuria,urinary tract infection,urethral stricture,bladder contracture,etc.The incidence of bladder irritation was not statistically significant between them[P(AB)=0.532,P(AC)=0.390,P(BC)=0.829];The incidence of hematuria was not statistically significant between them[P(AB)=0.760,P(AC)=0.522,P(BC)=0.751];The incidence of urinary tract infections was not statistically significant between them[P(AB)=0.348,P(AC)=0.643,P(BC)=0.632];the above symptoms were relieved after symptomatic treatment.Groups A and C had no serious complications such as bladder contractureln group B,one case of bladder contracture occurred and radical radical bladder surgery was performed;in group A,one case of urethral stricture occurred and gemcitabine was treated with bladder perfusion after dilatation of urethral stricture.The postoperative recurrence rate after six month was not statistically significant(p>0.05);The postoperative recurrence rate after one year was no significant difference in the recurrence rate between group A and group B in the postoperative recurrence rate after one year(p>0.05),and group A and group C,group B and group C was statistically significant(p<0.05);the postoperative tumor progression rate was no significant difference between them(p>0.05).Conclusion1.HIVEC with GEM or MMC has obvious advantages over intravesical instillation with GEM in preventing tumor recurrence in 1 year after TURBT with NMIBC.2.HIVEC with GEM as a new adjuvant treatment of TURBT is safe and effective,and worthy of studying. |
PDF Full Text Request