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2.
Int. braz. j. urol ; 48(1): 89-98, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356281

ABSTRACT

ABSTRACT Purpose: Contrast-enhanced CT scan is the standard staging modality for patients with bladder cancer undergoing radical cystectomy (RC). Involvement of lymph nodes (LN) determines prognosis of patients with bladder cancer. The detection of LN metastasis by CT scan is still insufficient. Therefore, we investigated various CT scan characteristics to predict lymph node ratio (LNR) and its impact on survival. Also, pre-operative CT scan characteristics might hold potential to risk stratify cN+ patients. Materials and Methods: We analyzed preoperative CT scans of patients undergoing RC in a tertiary high volume center. Retrospectively, local tumor stage and LN characteristics such as size, morphology (MLN) and number of loco-regional LN (NLN) were investigated and correlation to LNR and survival was analyzed. CT scan characteristics were used to develop a risk stratification using Kaplan-Maier and multivariate analysis. Results: 764 cN0 and 166 cN+ patients with complete follow-up and imaging data were included in the study. Accuracy to detect LN metastasis and locally advanced tumor stage in CT scan was 72% and 62%. LN larger than 15mm in diameter were significantly associated with higher LNR (p=0.002). Increased NLN correlated with decreased CSS and OS (p=0.001: p=0.002). Furthermore, CT scan based scoring system precisely differentiates low-risk and high-risk profiles to predict oncological outcome (p <0.001). Conclusion: In our study, solely LN size >15mm significantly correlated with higher LNR. Identification of increased loco-regional LN was associated with worse survival. For the first time, precise risk stratification based on computed-tomography findings was developed to predict oncological outcome for clinical lymph node-positive patients undergoing RC.


Subject(s)
Humans , Urinary Bladder Neoplasms/surgery , Urinary Bladder Neoplasms/pathology , Urinary Bladder Neoplasms/diagnostic imaging , Cystectomy , Prognosis , Tomography, X-Ray Computed , Retrospective Studies , Lymph Node Excision , Lymph Nodes/surgery , Lymph Nodes/pathology , Lymph Nodes/diagnostic imaging , Neoplasm Staging
3.
Int. braz. j. urol ; 48(1): 18-30, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356273

ABSTRACT

ABSTRACT Purpose: A systematic review of the literature with available published literature to compare ileal conduit (IC) and cutaneous ureterostomy (CU) urinary diversions (UD) in terms of perioperative, functional, and oncological outcomes of high-risk elderly patients treated with radical cystectomy (RC). Protocol Registration: PROSPERO ID CRD42020168851. Materials and Methods: A systematic review, according to the PRISMA Statement, was performed. Search through the Medline, Embase, Scopus, Scielo, Lilacs, and Cochrane Database until July 2020. Results: The literature search yielded 2,883 citations and were selected eight studies, including 1096 patients. A total of 707 patients underwent IC and 389 CU. Surgical procedures and outcomes, complications, mortality, and quality of life were analyzed. Conclusions: CU seems to be a safe alternative for the elderly and more frail patients. It is associated with faster surgery, less blood loss, lower transfusion rates, a lower necessity of intensive care, and shorter hospital stay. According to most studies, complications are less frequent after CU, even though mortality rates are similar. Studies with long-term follow up are awaited.


Subject(s)
Humans , Aged , Urinary Diversion/adverse effects , Urinary Bladder Neoplasms/surgery , Quality of Life , Ureterostomy , Cystectomy/adverse effects
4.
Einstein (Säo Paulo) ; 20: eAO6450, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364794

ABSTRACT

ABSTRACT Objective To understand the feasibility of FGFR3 tests in the Brazilian public health context, and to sample the mutational burden of this receptor in high-grade muscle invasive bladder cancer. Methods A total of 31 patients with high-grade muscle-invasive bladder cancer were included in the present study. Either transurethral resection of bladder tumor or radical cystectomy specimens were analyzed. Formalin-fixed paraffin-embedded tissue blocks were sectioned, hematoxylin and eosin stained, and histologic sections were reviewed. Total RNA was extracted using the RNeasy DSP formalin-fixed paraffin-embedded kit. Qualitative results were displayed in Rotor-Gene AssayManager software. Results Six patients were excluded. From the samples analyzed, four (16.7%) were considered inadequate and could not have their RNA extracted. Two patients presented FGFR3 mutations, accounting for 9.5% of material available for adequate analysis. The two mutations detected included a Y373C mutation in a male patient and a S249C mutation in a female patient. Conclusion FGFR3 mutations could be analyzed in 84% of our cohort and occurred in 9.5% of patients with high-grade muscle invasive bladder cancer in this Brazilian population. FGFR3 gene mutations are targets for therapeutic drugs in muscle-invasive bladder cancer. For this reason, know the frequency of these mutations can have a significant impact on public health policies and costs provisioning.


Subject(s)
Urinary Bladder Neoplasms/genetics , Carcinoma, Transitional Cell/genetics , Carcinoma, Transitional Cell/metabolism , Carcinoma, Transitional Cell/pathology , Receptor, Fibroblast Growth Factor, Type 3/genetics , Receptor, Fibroblast Growth Factor, Type 3/metabolism , Brazil , RNA , Prevalence , Eosine Yellowish-(YS) , Hematoxylin , Muscles/metabolism , Muscles/pathology , Mutation
5.
MedUNAB ; 24(3): 353-358, 202112.
Article in Spanish | LILACS | ID: biblio-1353586

ABSTRACT

Introducción. El compromiso tumoral metastásico del melanoma al tracto genitourinario es frecuente, pero, la metástasis a vejiga es rara, constituye menos del 2% de los casos. Sin embargo, en autopsias realizadas a pacientes con melanoma se ha encontrado metástasis en la vejiga en entre un 18% y un 37% de los casos, lo que la convierte en la segunda en incidencia posterior al adenocarcinoma gástrico. La media de supervivencia suele ser entre 6 - 7.5 meses. El objetivo de este trabajo es presentar el caso de un melanoma metastásico a vejiga, entidad poco frecuente y poco diagnosticada por ser la mayoría de las veces asintomática. Presentación del caso. Paciente femenina de 62 años, con antecedente de melanoma al nivel del primer artejo del pie, con manejo quirúrgico y farmacológico. Consultó por hematuria. La cistoscopia evidenció una lesión única sólida, eritematosa, con necrosis y fácil sangrado y se indicó realizar resección transuretral (RTU). La patología demostró compromiso por melanoma ulcerado metastásico. Se inició manejo de segunda línea (Pembrolizumab) y presentó progresión a miembros superiores y recaída a nivel vesical. La paciente falleció un año después. Discusión. Las metástasis de melanoma al tracto genitourinario son frecuentes, pero las metástasis vesicales aisladas son raras. El tratamiento suele ser RTU de la lesión, cistectomía, quimioterapia y radioterapia. La RTU es curativa para las lesiones restringidas al epitelio, aunque la cistectomía radical suele ser la terapia de elección ante un paciente con un tumor localizado. El Pembrolizumab ha demostrado aumentar la supervivencia. El pronóstico depende del tamaño y profundidad de la invasión. Conclusiones. El compromiso vesical metastásico es poco frecuente y diagnosticado, puede estar presente en pacientes con melanoma, síntomas irritativos urinarios no específicos y hematuria. Suele ser de mal pronóstico, y requiere de manejo quirúrgico asociado a manejo sistémico.


Introduction. Metastatic tumor compromise of melanoma to the genitourinary tract is frequent, but metastasis to the bladder is rare, representing less than 2% of cases. However, autopsies performed on patients with melanoma have found metastases in the bladder in 18-37% of cases, making it the second incidence after gastric adenocarcinoma. The median survival is usually 6 to 7.5 months. The objective of this work is to present the case of a metastatic melanoma to the bladder, a rare and underdiagnosed condition because most of the time it is asymptomatic. Case Presentation. 62-year-old female patient, with a history of melanoma at the level of the first toe, with surgical and pharmacological management. The reason for consultation was hematuria. Cystoscopy revealed a single solid, erythematous lesion with necrosis and easy bleeding, and a transurethral resection (TUR) was indicated. The pathology found compromise for metastatic ulcerated melanoma. Second-line treatment (Pembrolizumab) was started and presented progression to the upper limbs and relapse at the bladder level. The patient died a year later. Discussion. Melanoma metastases to the genitourinary tract are common, but isolated bladder metastases are rare. Treatment is usually TUR of the lesion, cystectomy, chemotherapy, and radiation therapy. TUR is curative for lesions restricted to the epithelium, although radical cystectomy is usually the therapy of choice in patients with a localized tumor. Pembrolizumab has been shown to increase survival. The prognosis depends on the size and depth of the invasion. Conclusions. Metastatic bladder compromise is rare and underdiagnosed, it may be present in patients with melanoma, non-specific urinary irritative symptoms, and hematuria. It tends to have a poor prognosis, and requires surgical management associated with systemic management.


Introdução. O comprometimento do tumor metastático do melanoma no trato geniturinário é comum, mas a metástase na bexiga é rara, constituindo menos de 2% dos casos. Entretanto, em autópsias realizadas em pacientes com melanoma, foi encontrada metástase na bexiga entre 18% e 37% dos casos, o que a torna a segunda em incidência após o adenocarcinoma gástrico. A média de sobrevivência é geralmente entre 6 - 7,5 meses. O objetivo deste trabalho é apresentar o caso de um melanoma metastático na bexiga, uma entidade pouco frequente e subdiagnosticada, pois na maioria das vezes é assintomática. Apresentação do caso. Paciente do sexo feminino, 62 anos, com antecedentes de melanoma no nível do hálux, com manejo cirúrgico e farmacológico. Ela consultou por hematúria. A cistoscopia revelou uma única lesão sólida, eritematosa com necrose e sangramento fácil, e foi indicada uma ressecção transuretral (RTU). A patologia mostrou comprometimento de melanoma ulceroso metastático. O tratamento de segunda linha (Pembrolizumab) foi iniciado e a patologia avançou para os membros superiores e uma recaída no nível da bexiga. A paciente morreu um ano depois. Discussão. As metástases de melanoma para o trato geniturinário são frequentes, mas as metástases vesicais isoladas são raras. O tratamento é geralmente RTU da lesão, cistectomia, quimioterapia e radioterapia. A RTU é curativa para lesões restritas ao epitélio, embora a cistectomia radical seja geralmente a terapia de escolha para um paciente com um tumor localizado. O Pembrolizumab demonstrou aumentar a sobrevivência. O prognóstico depende do tamanho e da profundidade da invasão. Conclusões. O comprometimento vesical metastático é raro e subdiagnosticado, pode estar presente em pacientes com melanoma, sintomas irritantes urinários não específicos e hematúria. Geralmente tem um prognóstico negativo e requer manejo cirúrgico em associação com manejo sistêmico.


Subject(s)
Urinary Bladder Neoplasms , Urology , Hematuria , Melanoma , Neoplasm Metastasis
7.
Int. braz. j. urol ; 47(5): 1072-1073, Sept.-Oct. 2021.
Article in English | LILACS | ID: biblio-1286814

ABSTRACT

ABSTRACT Introduction: One of the most remarkable characteristics of urothelial carcinomas is multifocality. However, occurrence of synchronous bladder cancer and upper urinary tract urothelial cancer (UTUC) is exceptional. Minimally invasive approach for these synchronous tumors was just occasionally reported (1-4). The aim of this video article is to describe step-by-step the technique for simultaneous laparoscopic nephroureterectomy and robot-assisted anterior pelvic exenteration with intracorporeal ileal conduit urinary diversion (ICUD). Patients and methods: A 66-year-old female presented with synchronous BCG refractory non-muscle invasive bladder cancer and a right-side UTUC. She was a former smoker and had previously been submitted to multiple transurethral resections of bladder tumor, BCG and right distal ureterectomy with ureteral reimplant. We performed a simultaneous laparoscopic right nephroureterectomy and robot-assisted anterior pelvic exenteration with totally intracorporeal ICUD. Combination of robot-assisted and pure laparoscopic approaches was proposed focusing on optimization of total operative time (TOT). Results: Surgery was uneventful. TOT was of 330 minutes. Operative time for nephroureterectomy, anterior pelvic exenteration and ICUD were 48, 135, 87 minutes, respectively. Estimated blood loss was 150mL. Postoperative course was unremarkable and patient was discharged after 7 days. Histopathological evaluation showed a pT1 high grade urothelial carcinoma plus carcinoma in situ both in proximal right ureter and bladder, with negative margins. Twelve lymph nodes were excised, all of them negative. Conclusion: In our preliminary experience, totally minimally invasive simultaneous nephroureterectomy and cystectomy with intracorporeal ICUD is feasible. Pure laparoscopic approach to upper urinary tract may be a useful tactic to reduce total operative time.


Subject(s)
Humans , Pelvic Exenteration , Urinary Diversion , Urinary Bladder Neoplasms/surgery , Robotics , Laparoscopy , Cystectomy , Nephroureterectomy
8.
Int. braz. j. urol ; 47(5): 1006-1019, Sept.-Oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286808

ABSTRACT

ABSTRACT Objective: To characterize the contribution of the extirpative and reconstructive portions of radical cystectomy (RC) to complications rates, and assess differences between urinary diversion (UD) types. Materials and Methods: We conducted a retrospective cohort study comparing patients undergoing UD alone or RC+UD for bladder cancer from 2006 to 2017 using ACS National Surgical Quality Improvement Program database. The primary outcome was major complications, while secondary outcomes included minor complications and prolonged length of stay. Propensity score matching (PSM) was utilized to assess the association between surgical procedure (UD alone or RC+UD) and outcomes, stratified by diversion type. Lastly, we examined differences in complication rates between ileal conduit (IC) vs. continent UD (CUD). Results: When comparing RC + IC and IC alone, PSM yielded 424 pairs. IC alone had a lower risk of any complication (HR 0.63, 95% CI 0.52-0.75), venous thromboembolism (HR 0.45, 95% CI 0.22-0.91) and bleeding needing transfusion (HR 0.41, 95% CI 0.32-0.52). This trend was also noted when comparing RC + CUD to CUD alone. CUD had higher risk of complications than IC, both with (56.6% vs 52.3%, p = 0.031) and without RC (47.8% vs 35.1%, p=0.062), and a higher risk of infectious complications, both with (30.5% vs 22.7%, p<0.001) and without RC (34.0% vs 22.0%, p=0.032). Conclusions: RC+UD, as compared to UD alone, is associated with an increased risk of major complications, including bleeding needing transfusion and venous thromboembolism. Additionally, CUD had a higher risk of post-operative complication than IC.


Subject(s)
Humans , Urinary Diversion/adverse effects , Urinary Bladder Neoplasms/surgery , Surgeons , Postoperative Complications/epidemiology , United States , Cystectomy/adverse effects , Retrospective Studies , Treatment Outcome , Quality Improvement
11.
Int. braz. j. urol ; 47(4): 803-818, Jul.-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286784

ABSTRACT

ABSTRACT Background: Guideline-based best practice treatment for muscle invasive bladder cancer (MIBC) involves neoadjuvant chemotherapy followed by radical cystectomy (NACRC). Prior studies have shown that a minority of patients receive NACRC and older age and renal function are drivers of non-receipt of NACRC. This study investigates treatment rates and factors associated with not receiving NACRC in MIBC patients with lower comorbidity status most likely to be candidates for NACRC. Materials and Methods: Retrospective United States National Cancer Database analysis from 2006 to 2015 of MIBC patients with Charlson comorbidity index (CCI) of zero. Analysis of NACRC treatment trends in higher CCI patients was also performed. Results: 15.561 MIBC patients met inclusion criteria. 1.507 (9.7%) received NACRC within 9 months of diagnosis. NACRC increased over time (15.0% in 2015 compared to 3.6% in 2006). Higher NACRC was noted in females, cT3 or cT4 cancer, later year of diagnosis, and academic facility treatment. Lower utilization was noted for blacks and NACRC decreased with increasing age and CCI. Only 16.9% of patients aged 23-62 in the lowest age quartile with muscle invasive bladder cancer and CCI of 0 received NACRC. Conclusions: Although utilization is increasing, receipt of NACRC remains low even in populations most likely to be candidates. Further study should continue to elucidate barriers to utilization of NACRC.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Young Adult , Urinary Bladder Neoplasms/surgery , Urinary Bladder Neoplasms/drug therapy , United States , Comorbidity , Cystectomy , Retrospective Studies , Neoadjuvant Therapy , Muscles , Neoplasm Invasiveness
14.
Int. braz. j. urol ; 47(3): 584-593, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154495

ABSTRACT

ABSTRACT Introduction: The aim of the present prospective-randomized study was to compare perioperative outcomes and complications of bipolar and monopolar TURBT for lateral wall-located non-muscle invasive bladder cancers (NMIBC) under obturator nerve block (ONB). Patients and Methods: 80 patients who underwent TURBT for lateral wall-located primary bladder tumors under ONB from March, 2016 to November, 2019 were included in the present study. The patients were randomized equally into two groups; monopolar TUR (M-TURBT) and bipolar TUR (B-TURBT). The primary and secondary outcomes were safety (obturator jerk and bladder perforation) and efficacy (complete tumor resection and sampling of the deep muscle tissue). Results: Obturator jerk was detected in 2 patients (5%) in M-TURBT while obturator jerk was not observed during B-TURBT (p=0.494). Bladder perforation was not observed in both groups. All of the patients underwent complete tumor resection. There was no significant difference in muscle tissue sampling (67.5% vs. 72.5%, p=0.626) and thermal tissue damage rates (12.5% vs. 25%, p=0.201). The majority of complications were low-grade and the differences in Clavien grade 1-3 complications between groups were not statistically significant. Conclusion: In the treatment of lateral-wall located NMIBCs, either M-TURBT or B-TURBT can be safely and effectively performed by combining spinal anesthesia with ONB. Even so, it should be taken into consideration that low-grade postoperative hemorrhagic complications may occur in patients who undergo M-TURBT.


Subject(s)
Humans , Urinary Bladder Neoplasms/surgery , Urologic Surgical Procedures , Cystectomy , Prospective Studies , Obturator Nerve
15.
Int. braz. j. urol ; 47(3): 503-514, May-June 2021. tab
Article in English | LILACS | ID: biblio-1154498

ABSTRACT

ABSTRACT Purpose: Proteomic biomarkers have been emerging as alternative methods to the gold standard procedures of cystoscopy and urine cytology in the diagnosis and surveillance of bladder cancer (BC). This review aims to update the state of the art of proteomics research and diagnosis in BC. Materials and Methods: We reviewed the current literature related to BC research on urinary, tissue, blood and cell line proteomics, using the Pubmed database. Findings: Two urinary protein biomarkers are FDA-approved (NMP22® and BTA® tests), only if performed along with cystoscopy for surveillance after initial diagnosis, but not in the primary diagnostic setting due to high false-positive rates in case of infections, stones and hematuria. There are a great number of non-FDA approved proteins being studied, with good preliminary results; panels of proteins seem valuable tools to be refined in ongoing trials. Blood proteins are a bigger challenge, because of the complexity of the serum protein profile and the scarcity of blood proteomic studies in BC. Previous studies with the BC tissue proteome do not correlate well with the urinary proteome, likely due to the tumor heterogeneity. Cell line proteomic research helps in the understanding of basic mechanisms that drive BC development and progression; the main difficulty is culturing low-grade tumors in vitro, which represents the majority of BC tumors in clinical practice. Conclusion: Protein biomarkers have promising value in the diagnosis, surveillance and prognostic of BC. Urine is the most appropriate body fluid for biomarker research in BC due to its easiness of sampling, stability and enrichment of shed and secreted tumor-specific proteins. Panels of biomarkers may exhibit higher sensitivity than single proteins in the diagnosis of BC at larger populations due to clinical and tumor heterogeneity. Prospective clinical trials are warranted to validate the relevance of proteomic data in the clinical management of BC.


Subject(s)
Humans , Urinary Bladder Neoplasms/diagnosis , Biomarkers, Tumor , Prospective Studies , Sensitivity and Specificity , Cystoscopy , Proteomics
16.
Rev. bras. anal. clin ; 53(1): 28-31, 20210330.
Article in Portuguese | LILACS | ID: biblio-1290945

ABSTRACT

O câncer de bexiga se inicia nas células que revestem a bexiga as quais sofrem um crescimento anormal devido às mutações. O carcinoma urotelial é o nono tipo de câncer mais frequente no mundo, e em geral é diagnosticado como uma doença superficial. O objetivo dessa pesquisa é saber quais são os riscos prevalentes para o câncer de bexiga. O levantamento bibliográfico desta revisão foi realizado por meio de busca por artigos científicos encontrados em bancos de dados da Scielo, Pubmed, Biblioteca Virtual em saúde (BVS) e no Google acadêmico. Foram utilizados ao todo 23 artigos, sendo artigos científicos, resumos e revisões no período de dezembro de 2019. Nas últimas décadas, a incidência global desse câncer parece estar crescendo e isso poderá ser consequência dos efeitos dos riscos. Cerca de 20% dos casos de câncer de bexiga estão associados a riscos de exposição ocupacional, tabagismo, carcinógenos industriais, as aminas aromáticas, substâncias químicas orgânicas, e uma série de atividades profissionais. Também, consideram-se risco os medicamentos, a dieta e as infecções por parasitas. Nesta pesquisa foram apresentados os principais riscos estabelecidos e propostos ao desenvolvimento do câncer de bexiga.


Bladder cancer begins in the cells lining the bladder that undergo abnormal growth due to mutations. Urothelial carcinoma and the ninth most common cancer in the world, is generally diagnosed as a superficial disease. The purpose of this research is to find out what are the prevalent risks for bladder cancer. The bibliographic survey of this review was carried out by searching for scientific articles found in Scielo, PubMed, Virtual Health Library (VHL) databases and in Google academic. A total of 23 articles were used, including scientific articles, abstracts, reviews in the period of December 2019. In the last decades, the global incidence of this cancer seems to be increasing and this may be a consequence of the effects of the risks. About 20% of bladder cancer cases are associated with occupational exposure risks, smoking, industrial carcinogens, aromatic amines, organic chemicals in a range of professional activities. Also, drugs, diet and parasite infections are considered risky. This research presented the main risks established and proposed for the development of bladder cancer.


Subject(s)
Tobacco Use Disorder , Urinary Bladder Neoplasms , Diet , Infections , Neoplasms
17.
Int. braz. j. urol ; 47(2): 426-435, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154471

ABSTRACT

ABSTRACT Objective: To assess the functional outcomes and complications of modified Hautmann neobladder with Wallace ureteroileal anastomosis on a 6-8 cm long isoperistaltic chimney, following radical cystectomy. Materials and Methods: Between January 2015 and October 2019, 22 patients (18 men and 4 women) underwent radical cystectomy and Hautmann neobladder reconstruction with chimney modification and Wallace I ureteroileal anastomosis. The mean age of patients was 61 years (45-74 years). All procedures were performed by the same surgeon and the mean follow-up was 29.4 months. Complications were registered as early (occurring within 3 months) or late (occurring after 3 months), with particular attention addressed to the ureteroileal anastomotic stricture and anastomotic leakage rate. Patient evaluation also included symptom analysis for daytime continence and voiding frequency. Results: Ureteroileal anastomotic stricture was not detected as a cause of hydronephrosis. Hovewer, the anastomotic leakage occurred in one patient during the early postoperative period. Early complications occurred in 9 patients and the most common was bilateral hydronephrosis, detected in 5 examinees. Late complications occurred in 4 patients. Complete daytime and nighttime continence achieved in 18 and 16 patients respectively, with two patients (9%) still required intermittent catheterization three months after surgery. Conclusions: The functional results with modified Hautmann neobladder, incorporating short afferent limb in Wallace I uretero-enteric anastomosis, were efficient. This technique is an effective way to minimize potential uretero-enteric stricture, anastomotic leakage and incidence of vesicoureteral reflux.


Subject(s)
Humans , Male , Female , Urinary Diversion/adverse effects , Urinary Bladder Neoplasms/surgery , Postoperative Complications , Anastomosis, Surgical/adverse effects , Cystectomy/adverse effects , Follow-Up Studies , Ileum/surgery , Middle Aged
20.
Rev. medica electron ; 43(1): 2903-2916, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156783

ABSTRACT

RESUMEN Introducción: el cáncer de la vejiga es la segunda neoplasia urológica. En Cuba constituye la séptima causa de cáncer en el sexo masculino y entre las primeras quince, cuando se combinan ambos sexos. Objetivo: evaluar el comportamiento del cáncer de vejiga en pacientes del Hospital Universitario Comandante "Faustino Pérez Hernández". Materiales y Métodos: se realizó un estudio observacional, descriptivo y transversal en el período comprendido desde diciembre de 2014 hasta enero de 2020. Los pacientes se dividieron en tres grupos tratados con cirugía de mínimo acceso, cirugía abierta y no operados, se describieron los grupos histológicos y estadiaje tumoral y se les aplicó tratamiento según protocolo del servicio, sus complicaciones y la presencia de recidivas tumorales también fueron descritas. En el universo se incluyeron en el estudio 222 pacientes diagnosticados de cáncer de vejiga. Resultados: se comprobó que el mayor número de pacientes diagnosticados con cáncer de vejiga son del sexo masculino, el tipo histológico es el carcinoma de células uroteliales de bajo grado y el estadio T1. Las recidivas se presentaron antes de los 5 años en el 10,8% de los casos. 196 pacientes presentaron complicaciones. Conclusiones: el cáncer de vejiga es más frecuente en las edades comprendidas entre 60 a 69 años, las recidivas aparecieron mayormente entre 1 y 3 años. Se presentó complicaciones en 196 pacientes, siendo la cirugía la modalidad terapéutica que mayor por ciento tuvo con un 32.22% y las infecciones son las complicaciones más frecuentes (AU).


SUMMARY Introduction: Cancer of the bladder (CV) is the second urological neoplasm. In Cuba it constitutes the seventh cause of cancer in males and among the first fifteen, when both sexes are combined. Objective: To evaluate the behavior of bladder cancer (CV) in patients of the Faustino Pérez Hernández Hospital. Materials and methods: An observational, descriptive and cross-sectional study was carried out in the period from December 2014 to January 2020. The patients were divided into 3 groups treated with Minimum Access Surgery (CMA), Open Surgery (CA) and No Operated (NO), the histological groups and tumor staging were described and treatment was applied according to the service protocol, their complications and the presence of tumor recurrences were also described.Universe: 222 patients diagnosed with bladder cancer were included in the study. Results: It was found that the greatest number of patients diagnosed with CV are male, the histological type is low-grade urothelial cell carcinoma and stage T1. Recurrences occurred before 5 years in 10.8% of cases. 196 patients presented complications. Conclusions: The CV is more frequent in the ages between 60 to 69 years, the recurrences appeared mainly between 1 and three years. Complications occurred in 196 patients, with Surgery being the therapeutic modality with the highest percentage with 32.22% and infections being the most frequent complications (AU).


Subject(s)
Humans , Urinary Bladder Neoplasms/epidemiology , Carcinoma/epidemiology , Infections/etiology , Urinary Bladder Neoplasms/surgery , Urinary Bladder Neoplasms/complications , Urinary Bladder Neoplasms/diagnosis , Carcinoma/surgery , Carcinoma/complications , Carcinoma/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study
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