[A clinical study on urethral recurrence observed after cystectomy].
A clinical study was made on 108 male patients who underwent cystectomy. The posterior urethra and partial anterior urethra were removed in 47 cases, half of the perpendicular urethra was removed in 13 cases and the anterior urethra up to the fossa navicularis was removed in 48 cases. Out of 60 cases without urethrectomy, urethral recurrence was observed in 13 cases (21.7%), while no recurrence was observed in the cases treated with urethrectomy. The average period of time from cystectomy to urethral recurrence was 24.7 months (11-39 months). Urethral cancer of such early stages as pIa and pIb were found in 3 and 6 cases, respectively. Stage pT2 was found in 4 cases. Grade 1 cancer was found in 3 cases, grade 2, in 5 cases, and 3 in 5 cases. The proximal end of the perpendicular urethra was found to be the most frequent site for recurrence with 11 cases exhibiting recurrence at this location and 2 cases at the mid-portion of the perpendicular urethra. Many cases exhibited multiple recurrence of tumor of visually grayish, velvety and non-papillary type which was histologically all transitional cell carcinoma. Bladder tumor with higher grade tended to cause urethral cancer recurrence with higher grade. Bladder tumors at multiple locations from the trigone to the lateral and posterior walls tended to cause recurrence in the urethra (p less than 0.05). Of all the cases, 10 cases underwent urethrectomy and 2 cases penectomy. 12 cases received chemotherapy and 5 cases radiation therapy as postoperative adjuvant treatments.(ABSTRACT TRUNCATED AT 250 WORDS)
Yasumoto
R
R
Department of Urology, Osaka City University Medical School.
Asakawa
M
M
Yoshihara
H
H
Sakamoto
W
W
Iseki
T
T
Nakatani
T
T
Wada
S
S
Kishimoto
T
T
Maekawa
M
M
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D015653:Cystectomy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D013997:Time Factors; D014521:Urethra / Q000601:surgery; D014523:Urethral Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery*