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DETERMINAN LOS FACTORES PRONOSTICOS Y LA INFLUENCIA DE LA TERAPIA INTRAVESICAL EN LA RECURRENCIA DEL CANCER VESICAL NO INFILTRANTE DE MUSCULO

DETERMINAN LOS FACTORES PRONOSTICOS Y LA INFLUENCIA DE LA TERAPIA INTRAVESICAL EN LA RECURRENCIA DEL CANCER VESICAL NO INFILTRANTE DE MUSCULO

(especial para SIIC © Derechos reservados)
La recidiva previa durante el primer año y la multiplicidad (3 o más tumores) disminuyen el tiempo hasta la recurrencia superficial. Además, una técnica quirúrgica apropiada y el empleo de instilaciones vesicales incrementan ese tiempo.
garciarodriguez9.jpg Autor:
Jorge García Rodríguez
Columnista Experto de SIIC

Institución:
Hospital Universitario Central de Asturias (HUCA)


Artículos publicados por Jorge García Rodríguez
Coautores
Jesús María Fernández Gómez* Safwan Escaf Barmadah* Roberto Carlos González Alvarez* Antonio Jalón Monzón* Javier Regadera Sejas** José Luis Martín Benito* 
Médico Urólogo, Hospital Universitario Central de Asturias (HUCA), Oviedo, España*
Medico Urologo, Hospital Universitario Central de Asturias (HUCA), Asturias, España**
Recepción del artículo
19 de Julio, 2008
Aprobación
5 de Noviembre, 2008
Primera edición
4 de Junio, 2009
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Introducción: Evaluamos, en cuanto a recurrencia, los factores pronósticos en el cáncer vesical no infiltrante de músculo y el efecto de la terapia intravesical. Material y métodos: Estudiamos 419 neoplasias vesicales. Realizamos análisis univariados y multivariados sobre 24 variables de estas neoplasias y valoramos distintos tratamientos. Resultados: Existieron diferencias significativas en el tiempo libre hasta la recurrencia, que fue menor en los tumores que recurrieron en menos de 12 meses, en los tumores múltiples (3 o más tumores) y de cúpula; además existieron diferencias estadísticamente significativas cuando se estudiaron dos grupos homogéneos de cirujanos. El empleo de instilaciones vesicales incrementó de forma independiente el tiempo hasta la recidiva. Se demostró que la recurrencia se produjo significativamente más tarde cuando se habían empleado dosis altas de BCG y terapia de mantenimiento. Conclusiones: Los siguientes factores resultaron independientes para explicar menor tiempo libre hasta la recurrencia superficial: recidiva en el primer año, multiplicidad, técnica quirúrgica, no empleo de lavados intravesicales, tratamiento con dosis bajas de BCG y terapia de inducción frente a mantenimiento. El empleo de instilaciones vesicales, con dosis altas de BCG y terapia de mantenimiento, incrementó de forma independiente el tiempo hasta la recidiva.

Palabras clave
cáncer vesical superficial, recurrencia, instilación endovesical


Artículo completo

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Abstract
Introduction: We assessed the predictive factors for recurrence of non-muscle invasive bladder cancer, and the effect of intravesical therapy. Material and Methods: We examined 419 bladder neoplasms. Univariate and multivariate analyses were done on 24 variables of these bladder neoplasms, and various treatments were assessed. Results: There were significant differences in the disease-free interval before recurrence, which was shorter in tumors recurring within 12 months, in multiple tumors (3 or more tumors), and bladder dome cancers. Also, there were statistically significant differences when two homogeneous groups of surgeons were studied. Intravesical instillation therapy increased time to relapse as an independent factor. A significant delay in recurrence was demonstrated when high BCG doses and maintenance treatment were used. Conclusions: Independent factors associated with shorter disease-free interval before recurrence, were the following: cancer relapse within the first year, multiple tumors, surgical procedure, non-use of bladder washing, treatment with low BCG doses, and induction intravesical therapy vs. maintenance treatment. Intravesical instillations using high BCG doses and BCG maintenance treatment, increased the period of time before relapse.

Key words
superficial bladder cancer, recurrence, intravesical instillation


Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Urología
Relacionadas: Anatomía Patológica, Geriatría, Inmunología, Medicina Interna, Oncología



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Enviar correspondencia a:
Jorge García Rodríguez, Hospital Universitario Central de Asturias (HUCA), 33010, Martínez Vigil Nº2 2º Derecha, Oviedo, España
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