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• W2083322143 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 May 2002Clinical Panurothelial Disease in Patients with Superficial Bladder Tumors: Therapeutic Implications E. SOLSONA, I. IBORRA, J.V. RICÓS, J.L. MONRÓS, J. RUBIO, and S. ALMENAR E. SOLSONAE. SOLSONA More articles by this author , I. IBORRAI. IBORRA More articles by this author , J.V. RICÓSJ.V. RICÓS More articles by this author , J.L. MONRÓSJ.L. MONRÓS More articles by this author , J. RUBIOJ. RUBIO More articles by this author , and S. ALMENARS. ALMENAR More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65073-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We established the prognostic and therapeutic implications of panurothelial involvement in patients with superficial bladder tumors for optimizing therapeutic approaches in those at risk for panurothelial involvement. Materials and Methods: We studied the records of 35 patients with clinical panurothelial disease. Since all of these patients presented with high risk superficial bladder cancer during followup, they were included in specific therapeutic and followup regimens. Radical procedures or conservative therapies were indicated mainly according to pathological examination and the recurrence pattern. Results: Panurothelial involvement was a late stage of a recurrent and diffuse process that essentially developed in sequences, in which all patients presented with high risk superficial bladder tumors. This process involved continued relapse after panurothelial involvement developed. Notably 19 patients (79.1%) at risk for recurrence had repeat relapse in the urothelium. In the upper urinary tract 12 patients (34.3%) had bilateral involvement, including 7 (41.2%) of 17 patients after cystectomy. We identified 2 subgroups of patients. The subgroup with a better prognosis included 27 patients in whom late panurothelial disease developed step by step after a complete response to intravesical therapy, including 14 (51.8%) who were free of disease. The other subgroup with a poor prognosis included 8 patients with concurrent bladder carcinoma in situ and prostate involvement as well as early panurothelial disease, of whom only 2 (25%) were disease-free. All patients underwent many therapeutic approaches. A mean of 7.5 surgical procedures per patient were done, including a mean of 5.5 transurethral resections, a mean of 1 conservative approach to the upper urinary tract and a mean of 1.1 radical procedures. At a median followup of 111 months 10 patients (28.5%) were disease-free but only 7 (20%) retained the bladder, while 19 (54.3%) died of tumor. Conclusions: Patients with high risk superficial bladder multifocal tumors and associated bladder carcinoma in situ are at high risk for panurothelial involvement. Radical cystectomy may be recommended in these patients when initially or during followup, concurrent high risk superficial bladder tumors and prostate involvement develop or prostate involvement recurs. For the upper urinary tract conservative therapies may be advisable when noninfiltrating tumors are diagnosed even after cystectomy due to the high rate of bilateral new onset disease. 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Google Scholar From the Departments of Urology and Pathology, Instituto Valenciano de Oncología, Valencia, Spain© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byDrewa T (2012) The Promises and Challenges of Tissue Engineering for Urinary DiversionJournal of Urology, VOL. 188, NO. 2, (351-352), Online publication date: 1-Aug-2012.Fradet Y, Grossman H, Gomella L, Lerner S, Cookson M, Albala D and Droller M (2007) A Comparison of Hexaminolevulinate Fluorescence Cystoscopy and White Light Cystoscopy for the Detection of Carcinoma In Situ in Patients With Bladder Cancer: A Phase III, Multicenter StudyJournal of Urology, VOL. 178, NO. 1, (68-73), Online publication date: 1-Jul-2007.SCHMIDBAUER J, WITJES F, SCHMELLER N, DONAT R, SUSANI M and MARBERGER M (2018) Improved Detection of Urothelial Carcinoma In Situ With Hexaminolevulinate Fluorescence CystoscopyJournal of Urology, VOL. 171, NO. 1, (135-138), Online publication date: 1-Jan-2004. Volume 167Issue 5May 2002Page: 2007-2011 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsbladder neoplasmsneoplasm metastasisurinary tracturotheliumbladderMetricsAuthor Information E. SOLSONA More articles by this author I. IBORRA More articles by this author J.V. RICÓS More articles by this author J.L. MONRÓS More articles by this author J. RUBIO More articles by this author S. ALMENAR More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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