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Objective To investigate the efficacy and safety of intravesical instillation with Sufuning (SFN) lotion for prevention of postoperative recurrence of bladder cancer. Methods A total of 240 bladder cancer patients who were diagnosed as bladder cancer and accepted trans-urethral resection of bladder tumor from January 2010 to June 2016 in Shanxi Provincial Cancer Hospital were randomly divided into the experimental group (120 cases) and the control group (120 cases) according to the envelope method. The patients in the experimental group were treated with SFN lotion for immediate intravesical instillation(250 mg for once), and the patients in the control group were treated with pirarubicin (THP) for immediate intravesical instillation (30 mg for once). The patients of two groups were treated with intravesical chemotherapy once a week for 8 times, and the chemotherapy was performed once a month for 1 year. The recurrence rate, progression-free survival (PFS) rate, overall survival (OS) rate and recent side effects were compared between the two groups. Results The patients were followed up for 6 to 60 months. The median follow-up time was 36.5 months.In the experimental group,6 patients were lost and 8 patients were lost in the control group.The experimental group, the total recurrence rate was 26.3 % (30/114). The control group, the overall recurrence rate was 25.0 % (28/112) (χ2= 0.142, P = 0.781). Five years of PFS rate in the experimental group and the control group was 73.7 % (84/114) and 75.0 % (84/112) respectively, and there was no significant difference between the two groups (χ2= 2.011, P= 0.615). Five years of OS rate in the experimental group and the control group was 95.6 % and 92.9 % respectively, and there was no significant difference between the two groups (χ 2= 1.611, P= 0.425). The major side effects included chemical cystitis and hematuria. The incidence of chemical cystitis and hematuria in the experimental group was significantly lower than that in the control group(χ2=5.991,P=0.018;χ2=4.925,P=0.036).There was a statistically significant difference of the hematological side effects (blood routine changes) between the two groups (χ 2= 4.891, P= 0.032). Conclusion It is safe and effective for intravesical instillation of SFN lotion to prevent the recurrence of bladder cancer.
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Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.
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Objective To investigate the efficacy of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced urinary tract urothelial carcinoma (UTUC).Methods The clinical data of 128 patients of locally advanced (T3,T4) UTUC treated with surgery with radioactive particle implantation plus postoperative GC chemotherapy (experimental group) and surgery plus postoperative GC chemotherapy (control group) were retrospectively analyzed.All the patients underwent complete resection of the tumor.The postoperative pathology was urinary tract epithelium cancer.In the experimental group,there were 45 (69.2％) males and 20 (30.8％) females,with median age 56.5 years.There were 39 (60.0％) patients diagnosed with renal pelvic cancer,including 13 (33.3 ％) patients with local lymph node metastasis;26 patients (40.0％) with ureteral cancer,11 patients (42.3％) with local lymph node metastasis.In the control group,there were 46 males (73.0％) and 17 females (27.0％),with median age 57.1 years.There were 40 (63.5％) patients with renal pelvic cancer,including 12 (30％) cases of local lymph node metastasis;23 patients with ureteral carcinoma (36.5％),including 10 patients (43.4％) with local lymph node metastasis.There was no significant difference in basehne data between the two groups (P ＞ 0.05).The recurrence and distant metastasis,recurrence-free survival,distant disease free survival(DDFS),disease-specific survival(DSS),overall survival (OS) and comphcations of two groups were compared.Results The follow-up time was 50.5 months (ranged 5 to 62 months).In experimental group,there were 2 cases,5 cases,11 cases,16 cases and 21 cases occurred recurrence and distant metastasis in 6 months,1 year,2 years,3 years and 5 years respectively,and the 5-year cumulative recurrence and distant rate was 32.3％ (21/65).In control group,there were 3 cases,5 cases,17 cases,21 cases and 32 cases,occurred recurrence and distant metastasis in 6 months,1 year,2year,3 year,5 year respectively,and the 5-year cumulative recurrence and distant rate was 50.8％(32/63).There was significant difference between the two groups (P =0.034).In the experimental group and the control group,the 5-year non-metastatic survival rates were 61.5％ (40/65)and 41.3％ (26/63),respectively.There was significant difference in 5-year non-metastatic survival rate between the two groups (P =0.033).The 5-year DSS rates were 69.2％ (45/65) and 50.8％ (32/63),respectively.The 5-year DSS rate of the two groups was significantly different (P =0.033).The 5-year OS rates were 53.8％ (35/65) and 36.5％ (23/63) respectively.There was significant difference in the 5-year OS rate between the two groups (P =0.049).Condusions Compared with surgery and chemotherapy,the use of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced stage (T3-T4) UTUC could achieve the total survival benefit,and less adverse reactions.
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Objective To investigate the safety and feasibility of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy. Methods 45 patients who were suitable for retroperitoneoscopic partial nephrectomy from February 2013 to February 2014 were collected and randomly divided into V-Loc group and the control group. 23 cases of V-Loc barbed absorbable suture line were chosen by suture kidney in V-Loc group.There were 22 cases of coated vicryl plus antibacterial suture and Hem-o-lok clip in the control group. The differences of operative time, blood loss, warm ischemia time, suture time, hospital stay and suture material costs were compared respectively between the two groups. Results All 45 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery and important intraoperative complications. Postoperative pathology report showed that there were 37 cases with renal clear cell carcinoma, 3 cases with papillary renal cell carcinoma, 2 cases with chromophobe renal cell carcinoma with negative surgical margin, 3 cases with renal angiomyolipomas. In the V-Loc group and the control group, the average operative time were (90.8±9.6) and (96.9±9.1) min (P>0.05), the mean blood loss were (80.4±24.2) and (99.5±24.8) ml (P>0.05), the mean warm ischemia time were (21.5±3.4) and (25.3±1.9) min (P0.05), the average cost of renal parenchymal suture material were (1 215.5±101.4) and (2 073.5±301.8) yuan (P<0.05). The warm ischemia time,suture time and suture material costs in the V-Loc group were significantly lower than those in the control group (all P<0.05). Conclusion The application of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy can shorten warm ischemia time and suture time, and save hospitalization costs, with favorable safety and feasibility.
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Objective To evaluate the efficacy and feasibility of 125I radioactive seed interstitial implantation for the local advanced urinary tract epithelial carcinoma without total resection.Methods The clinical data of 21 patients with local advanced urothelial carcinoma without completely surgical resection who were treated by 125I radioactive particles implantation were retrospectively analyzed.The patients were divided into two groups and received preoperative plan.In group A, 14 patients received implants during operations, including 7 bladder transitional cell carcinoma patients who underwent a transurethral resection surgery or partial bladder resection and another 7 ureteral carcinoma cases who underwent semi urine road resection.After these operations, all of patients had tumor residues.After furthest resection of the tumor, the 125I seeds were implanted at the residual suspicious tumors and their surroundings.In group B, 7 patients were implanted under the guidance of color ultrasound or CT.According to the evaluation criteria of solid tumor in 2009, the tumor remission rate, survival rate, distribution and the mobile information of the particles were observed.Results The operations were successfully completed in all of 21 patients, and serious complications did not appear during the operation.Particle distribution and lesions were basic coincidence.A total of 2 particles displaced, but every patient had no adverse reactions.There were 2 patients with local fever after operation within 4 months, while the rest of patients had no adverse reactions.After median follow-up for 36 months (3-75 months) , the 1-year survival rate was 100.0 ％ (21/21), the 2-year survival rate was 90.5 ％ (19/21), and the 3-year survival rate was 61.9 ％ (13/21).The tumor remission rate of group A was 85.7 ％ (12/14) after 6-9 months, and was 42.9 ％ (6/14) after 12 months.The bladder was preserved in 7 cases with bladder tumors with the 2-year survival rate of 100.0 ％ (7/7) and the 5-year survival rate of 71.4 ％ (5/7).The tumor remission rate of group B after 6-9 months was 71.4 ％ (5/7), and was 42.9 ％ (3/7) after 12 months.Conclusion 125I seed implantation is a good choice for locally advanced urothelial carcinoma with high local tumor control rate, which is expected to be applied in the individual treatment of advanced urothelial cancer.
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Objective To generate high purity and maturity DC from human peripheral blood monocytes in vitro.Methods PBMC were isolated directly from whole blood by density gradient centrifugation and purified by collecting the attached cell,DC were then generated by induction and culturing PBMC for five days with RPMI1640 medium containing rhGM-CSF and rhIL-4 in vitro,and under the condition of 37 ℃,5% CO2.On the fifth day,rhTNF-α was added into DCs cultures,which were then incubated for three additional days.The morphology was monitored by light microscopy,and the phenotypes were determined by FCM.Results After eight days of culture,the cells developed typical and significant dendritic morphology and plenty of cells expressed CD1a, CD80 and CD83,features of DC.Including(78.07±9.43)%CD1a,(60.11±20.50)% CD80 and(46.82±14.15)% CD83 were expressed.About (3.12±1.30)x106 DC cells were derived from 40ml human peripheral blood.Conclusion The way to generate DCs is simple and easy.The DCs produced by this method acquired high purity and maturity antigenic characteristics of DCs.