Recurrence of superficial bladder tumors in prostatic urethra.
Of our 276 patients with superficial bladder carcinoma, 242 were male, and 36 of these had recurrence in prostatic urethra, 26 with macroscopic tumors, and 10 with tumors in situ (TIS). These recurrences represent an incidence of 13.3%, with an average follow-up of 34.3 months. When the urethral tumor was limited to the mucosa, we chose conservative therapy, and the patients entered a random program with Mitomycin or Adriamycin administered endovesically. With this program, we could control the disease in 59.3% of the patients. However, 22.2% of them had recurrence with prostatic stromal infiltration, so that we performed a more exhaustive exploration of the prostate, taking biopsies not only at the 5 and 7 o'clock positions, but also making a wider resection in order to find the incipient infiltration of the prostatic stroma, and trying to avoid a possible understaging. When the urethral tumor had infiltrated the prostatic stroma, we performed cystoprostatourethrectomy, getting a survival rate free of disease of 40%. An association with vesical TIS was detected in 61.1% of these patients, with terminal ureteral tumor in 8.3% and with the anterior urethra in 11.1%, showing the diffuse pattern of the disease. We conclude that when recurrence of prostatic urethra is present, it is necessary to monitor the whole urothelium during follow-up.
Solsona
E
E
Department of Urology, Instituto Valenciano de Oncologia, Spain.
Iborra
I
I
Ricós
J V
JV
Monrós
J L
JL
Dumont
R
R
Casanova
J
J
Calabuig
C
C
D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000628:therapy; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D008937:Mitomycins / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000628:therapy*; D015996:Survival Rate; D014523:Urethral Neoplasms / Q000628:therapy*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000628:therapy*
D000970:Antineoplastic Agents; D008937:Mitomycins; D016685:Mitomycin; D004317:Doxorubicin