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Background: Muscle invasive bladder urothelium carcinoma is a common urinary tract tumor. With the deepening of research, more and more treatment methods are applied in clinical practice, extending the life of patients. Among them, the clinical application of chemotherapeutic intravesical hyperthermia and tumor immunotherapy provides new ideas for our treatment. Case report: An 81-year-old female patient was diagnosed with stage T2N0M0 bladder cancer in our hospital. Because the patient and her family were keen to preserve her bladder, they declined surgery and opted for combined chemotherapy. After informed consent from the patient and her family, she received cisplatin combined with gemcitabine intravesical hyperthermic infusion. But the side effects of cisplatin made her intolerable to chemotherapy. With their informed consent we changed her to intravenous tislelizumab in combination with gemcitabine intravesical hyperthermic infusion to continue her treatment. During the subsequent follow-up visits, we found a surprising effect of the treatment. Conclusion: Gemcitabine intravesical hyperthermia therapy combined with intravenous tislelizumab in the treatment of muscle invasive bladder urothelium carcinoma may provide a new possible therapeutic strategy of some patients who are inoperable or refuse surgery.
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Male primary urethral urothelium carcinoma is a rare clinical case. Here, we detail a case of a 58-year-old man with primary urothelium carcinoma of the distal urethra treated in our hospital. The patient with a neoplasm inside the external urethral orifice for 2 years, which was previously diagnosed as condyloma acuminata, had received photodynamic therapy for 3 times, with initial symptoms of urinary stream bifurcation and dysuria. The exfoliative urine cytology showed negative. Cystoscopy showed a tumor growing around the distal urethra. Biopsy and immunohistochemistry revealed high-grade papillary urothelium carcinoma. The patient received partial urethrectomy, followed by urinary bladder irrigation chemotherapy with epirubicin postoperatively. The corpus spongiosum was invaded while the corpus cavernosa were not. Postoperative pathological examination showed high-grade invasive urothelium carcinoma. There is no evidence of tumor recurrence, metastasis or surgical complications during a 61-month follow-up period. Male primary urethral urothelium carcinoma is a rare clinical case with particular clinical and pathological characteristics. There are still no established treatment guidelines and should be studied further.
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BACKGROUND: There is a high incidence rate of upper tract urothelial carcinoma (UTUC) in patients on dialysis. However, the studies about nephroureterectomy (NU) in this high surgical risk group are limited. The aim of this study is to investigate the outcomes of NU in this population. RESULTS: There were total 931 patients enrolled and 218, 582, 131 patients were non-NU, unilateral and one-stage bilateral NU, respectively. NU provided better 5-year overall survival (66% versus 51% in non-NU, P = 0.001). 19.7% of patients with unilateral NU had successive contralateral NU with a mean interval period of 695 days. Even for the elderly, there were no significant difference in duration of hospitalization, 30- and 90-day mortality between unilateral and bilateral NU. MATERIALS AND METHODS: Patients on dialysis with UTUC between January 1998 and December 2012 were assessed from the nationwide cohort of Taiwan National Health Insurance Research Database. We classified these patients into non-NU and NU groups. In NU group, we analyzed clinical outcomes of patient groups between different NU types and surgical methods. CONCLUSIONS: Although the high surgical risk in patients on dialysis with UTUC, NU provided better 5-year overall survival. One-stage bilateral NU both provides comparable safety profile and avoids 19.7% of successive contralateral NU in less than two years. Even in the elderly, one-stage bilateral NU is safe and feasible.
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Objective To analyze the clinical curative effect of retroperitoneoscopy combined with inguen small incision surgery in treatment of urothelium carcinoma.Methods Ninety-eight urothelium carcinoma patients were divided into observation group (56 cases) and control group (42 cases) according to the surgery method.The patients in observation group were treated with retroperitoneoscopy combined with inguen small incision surgery,and the patients in control group were treated with open surgery.The operation time,intraoperative bleeding volume,postoperative drainage volume,postoperative gastrointestinal function recovery time,postoperative ambulation time,drainage tube removal time,hospitalization time,incision fat liquefaction,incision hernia,incision prolapse,incision pain and discomfort,postoperative analgesia,postoperative 3 months incision satisfaction and postoperative 36 months tumor recurrence were observed.Results The operation time,intraoperative bleeding volume,postoperative gastrointestinal function recovery time,postoperative ambulation time and hospitalization time in observation group were significantly lower than those in control group:(135.23 ±32.18) min vs.(177.58 ±57.29) min,(119.33 ±35.02) ml vs.(161.29 ± 72.06) ml,(2.03 ± 0.73) d vs.(2.79 ± 0.79) d,(20.68 ± 9.75) h vs.(32.41 ± 11.12) h,(8.51 ± 0.93) d vs.(9.81 ± 2.21) d,and there were statistical differences (P ＜ 0.05 or ＜ 0.01).There were no statistical differences in postoperative drainage volume and drainage tube removal time between 2 groups (P ＞ 0.05).The rates of incision fat liquefaction,incision hernia,incision prolapse,incision pain and discomfort and postoperative analgesia in observation group were significantly lower than those in control group:1.79％ (1/56) vs.26.19％ (11/42),0 vs.11.90％ (5/42),0 vs.7.14％ (3/42),1.79％ (1/56) vs.11.90％ (5/42),1.79％ (1/56)vs.11.90％ (5/42),the rate of postoperative 3 months incision satisfaction in observation group (92.86％,52/56) was significantly higher than that in control group (78.57％,33/42),and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The rate of tumor recurrence in observation group (14.29％,8/56) was significantly lower than that in control group (47.62％,20/42),and there was statistical difference (P ＜ 0.01).Conclusions Retroperitoneoscopy combined with inguen small incision surgery in treatment of urothelium carcinoma can significantly reduce the patients' treatment and recovery time,improve the beauty of incision and patients' satisfaction degree,and reduce the postoperative tumor recurrence rate.
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Objective The purpose of this study was to observe the distribution of CD3+T lymphocyte in the tissue of bladder cancer and epithelium of paracancer area, and analyze the significance. Methods Biopsy was performed in 28 patients with bladder cancer, and the distribution and number of CD3+T lymphocyte in tissue of bladder cancer and epithelium of paracancer area were observed and compared using immunohistochemistry. Results Many of CD3+T lymphocytes could be observed in the epithelium of paracancer tissues, but CD3+T lymphocytes in cancer nests was few. The average number of CD3+T lymphocytes in every 5 typical microscope visual fields of paracancer tissues and cancer nests was 15 ±4.5 and 4 ±2.2, respectively, and the difference was significant ( <0.05) . Conclusion Distribution of CD3+T lymphocytes in bladder cancer nests and paracancer tissues was different, which may be related to the immune escape and prognosis of bladder cancer. It is worthy of further research.
