ABSTRACT
Objective To detect the efficacy of trimodality treatment combining transurethral resection of bladder tumor (TURBT), chemotherapy and radiotherapy for locally muscle-invasive bladder cancer.Methods From November 2007 to June 2013, 107 local muscle-invasive bladder cancer cases were treated by TURBT.Thirty-six cases ( group A) underwent the bladder-sparing trimodality treatment, aged from 42 to 88 years.Seventy -one cases (group B) underwent radical cystectomy,aged from 38 to 77 years.In group A, there were 19 cases of T2 , 13 cases of T3 , and 4 cases of T4a.Among those patients, 11 patients underwent gemcitabine/cisplatin ( GC ) systemic chemotherapy regimen, 15 patients underwent gemcitabine/cisplatin ( GC ) intrailliac artery chemotherapy regimen, and 10 patients underwent taxane/carboplatin ( TC) systemic chemotherapy regimen.In group B, there were 38 cases of T2 , 27 cases of T3 , 6 cases of T4a.The progress-free survival after 2 years was compared with the only radical cystectomy, and the efficacy among the three chemotherapy regimens was also evaluated.Results There is no statistical difference in age and tumor stage between the two groups.In group A, patients were followed up from 3 to 79 months, and 2 years′progress-free survival was 78.9%(15 cases) in T2 , 46.2%(6 cases) in T3 , and 0 in T4a.In group A, organ-sparing 2 years′progress-free survival was 58.3%, and 6 metastasis (16.7%) and 11 local relapse ( 30.6%) were detected during the follow-up period.In group B, patients were followed up from 2 to 65 months, and 2 years′progress-free survival was 76.3%in T2(29 cases), 55.6%(15 cases) in T3, and 16.7% (1 case) in T4a.Of all the patients in group B, 2 years′progress-free survival was 63.4%, and 22 metastasis ( 31.0%) and 16 local relapse ( 22.5%) were found during the follow-up period.There′s no statistical difference on 2 years′progress-free survival between the two groups, and the efficacy among the three chemotherapy regimens.Conclusions Two years′progress-free survival of bladder-preserving trimodality treatment was similar to that of radical cystectomy for local muscle-invasive bladder cancer.In term of treatment efficacy, stage T2 was much better than T3 and T4a .Each kind of chemotherapy regimen in trimodality treatment was equally effective.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical features of retroperitoneal bronchogenic cyst.</p><p><b>METHODS</b>The clinical data of 6 cases with retroperitoneal brochogenic cyst treated in Peking Union Medical College Hospital from April 1996 to October 2014 were retrospectively analyzed. The clinical manifestation, diagnosis, treatment and prognosis were analyzed.</p><p><b>RESULTS</b>Of the patients, 1 was male and 5 were female aging from 31 to 50 years with a mean age of 38.3 years. Three cases were diagnosed from physical examination, 2 cases from upper abdominal pain and 1 case from left flank pain. The cysts located in the left adrenal region, between the liver and the pancreas, and anterior aspect of the tail of the pancreas were seen in 4 cases, 1 case and 1 case, respectively. The major diameter was from 5 cm to 13 cm, and the mean major diameter was 7 cm. Ultrasonography and CT scan could reveal cystic, cystic-solid or solid masses. Color doppler flow imaging showed no obvious blood flow, and contrast-enhanced CT scans showed no enhancement or no obvious enhancement. Six cases were all misdiagnosed preoperatively. They all underwent operations via retroperitoneal laparoscopic resection for 3 cases, laparotomy for 2 cases and open flank resection for 1 case respectively. The pathological diagnoses were all bronchogenic cysts. Three symptomatic patients became asymptomatic after operations. Five patients had been followed up. During the follow-up of 2 months to 15 years, no recurrence had been found with CT scan.</p><p><b>CONCLUSIONS</b>Retroperitoneal bronchogenic cyst is rare and easily misdiagnosed. It should be considered in the differential diagnosis of a retroperitoneal mass. Most cysts are positioned in the left adrenal region and adjacent regions. Some cysts demonstrate soft tissue characteristics in image. After surgical removal, the patients have a good prognosis.</p>