RESUMO
A comparative study of radical transurethral resection (TUR) of bladder carcinomas (BC) was performed in standard conditions and the application of fluorescence cystoscopy (FCS) for diagnosis of early recurrence of BC and the extent of tumor aggressiveness and prognosis of the disease. We examined 174 elderly and senile age patients with BC through 4-6 weeks after surgery to re-endoscopic study, which includes the standard cystoscopy (CS), fluorescent cystoscopy (FCS) and the TUR--the area of post-biopsy scar and the fluorescent sites. The first group consisted of 95 patients who performed a traditional TUR, the second one of 79 patients whom TUR on the fluorescent control (TUR-FCS) was performed. Repeated endoscopic examination detected the fluorescence in 56 (58.9%) patients in 1st group and 28 (35.4%) patients in 2nd group. Endothelial swelling was revealed in 45 (47.4%) from 1st group and 19 (24.1%) among patients from 2nd one. Residual tumor was found significantly less frequently in patients from group 2, compared with the patients from 1st group. The significant difference was determined in frequency of residual tumor in pTa stage in patients from 1st and 2nd groups (16.8 and 8.9%, p < 0.005). The differences in frequency of residual papillary tumors in stage rT1, in the analyzed groups, were also significant (0.5 and 6.3% respectively, p < 0.05). The difference in frequency of relapses correlated significantly with the age of the patients. In 1st group, among the 27 patients with multiple lesion of the bladder, residual tumors were detected in 14 (51.9%). Among the 22 patients from the 2nd group who had the multiform BC, residual tumors were found only in 4 (18.2%) patients (p < 0.001). Early repeated cystoscopy and biopsy with the use of fluorescent monitoring should be recommended for patients with BC in stages Ta, Tis and T1. Early repeated cystoscopy and biopsy with the use of FCS enable the timely identification and removal of residual tumor and recurrence of superficial BC.
