Klinički tok karcinoma mokraćne bešike bez zahvatanja mišićnog sloja njenog zida posle transuretralne resekcije tumora sa ili bez naknadne intravezikalne aplikacije bacila Calmette-Guérin: uticaj pola i godina života bolesnika

  • Radovan Milošević Clinic of Urology Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Novak Milović Clinic of Urology Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Predrag Aleksić Clinic of Urology Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Miodrag Lazić Department of Urology, Clinical Hospital Center “Dr Dragiša Mišović”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Snežana Cerović Institute for Pathology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Rade Prelević Clinic of Urology, Military Medical Academy, Belgrade, Serbia
  • Aleksandar Spasić Clinic of Urology, Military Medical Academy, Belgrade, Serbia
  • Dejan Simić Clinic of Urology, Military Medical Academy, Belgrade, Serbia
  • Božidar Kovačević Institute for Pathology, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/6295
Ključne reči: urinary bladder neoplasms||, ||mokraćna bešika, neoplazme, recurrence||, ||recidiv, sex||, ||pol, age factors||, ||životno doba, faktori, risk factors||, ||faktori rizika, immunotherapy||, ||imunoterapija, urological surgical procedures||, ||hirurgija, urološka, procedure,

Sažetak


Uvod/Cilj. Intravezikalna imunoterapija bacilom Calmette-Guérin (BCG) smatra se zlatnim standardom u lečenju tumora mokraćne bešike bez zahvatanja mišićnog sloja [non-muscle invasive bladder cancer (NMIBC)] nakon transuretralne resekcije (TUR) tumora. Uloga i značaj BCG intravezikalne terapije za ishod lečenja, zavisno od oblika i veličine NMIBC, utvrđeni su našim prethodnim istraživanjem. Cilj ovog rada bio je da se utvrdi incidencija recidiviranja i progresije bolesti u zavisnosti od pola i životnog doba bolesnika. Metode. Ispitivanjem je obuhvaćeno 899 bolesnika sa NIMBC, lečenih u našoj instituciji od 1.1.2007 do 1.3.2013. Formirane su dve grupe bolesnika: bolesnici lečeni kombinacijom terapija TUR i BCG (grupa I) i bolesnici podvrgnuti samo terapiji TUR (grupa II). Ove dve grupe bolesnika podeljene su, zatim, u podgrupe: ispitanici  muškog i ženskog pola, stari 60 godina ili mlađi, i stariji od 60 godina. Statistička analiza obavljena je primenom χ2 testa i Kolmogorov-Smirnov testa. Rezultati. Posmatrajući učestalost recidiviranja kao jedini parametar, uzevši u obzir sve ispitanike, najniža stopa recidiva nađena je kod ispitanika muškog pola, starih 60 godina ili mlađih, koji su primali BCG nakon TUR-a. Visoka statistička značajnost u učestalosti recidiviranja nađena je kod mlađih od 60 godina, zavisno od primenjene terapije, dok je kod starijih od 60 godina ova razlika bila na nivou statističke značajnosti. Ovo se može pripisati određenom stepenu infravezikalne opstrukcije kod starijih muškaraca. Zaključak. Pol i starost bolesnika mogu imati značajan uticaj na tok i ishod NMIBC. Bolest se najmalignije i najagresivnije ponaša kada je prisutna kod osoba muškog pola, starijih od 60 godina.

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Objavljeno
2015/11/02
Broj časopisa
Vol. 72 Br. 7 (2015)
Rubrika
Originalni članak