Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-066)

방광 요관구에 발생하는 방광암과 상부요관부의 종양 재발 및 합병증에 관한 연구
서울대학교 의과대학 비뇨의학교실
유상현, 윤현식, 정규환, 박대형, 박재석, 한상헌, 서준교, 육형동, 정창욱, 김현회, 곽철, 구자현
Objective
Because ureteral orifice acts as an entrance to the upper urinary tract, bladder cancer can be more susceptible to recur of the upper tract if it occurs in ureteral orifice. There is another concern that resecting bladder orifice increases the risk of complications. In this study, we compared the rate of recurrence to the upper urinary tract between bladder cancer in ureteral orifice and other site bladder cancer. Also we analyzed the complication rate between two groups.

Material and Method
We selected patients from the Seoul National University Prospectively Enrolled Registry for Genitourinary Cancer – Transurethral Resection of Bladder tumor (SUPER-GUC-TURB), enrolled from March 2016 to December 2019. The eligible criteria was patients who received initial TURB, and exclusion criteria was the history of upper urinary tract cancer, and benign tumor in pathologic report or other type of bladder tumor such as adenocarcinoma. We analyzed recurrence rate by Kaplan-Meier methods and complication rate by unpaired T test.

Result
The finally selected patients were 757, with 68 cases of bladder cancer located near orifice, and 689 cases of bladder cancer located other sites. There was no significant difference in 3-year upper tract recurrence free survival (95.2% vs. 99.3% , orifice involved vs. control, p=0.296). Also 3-year recurrence free survival was not significantly different (64.4% vs. 61.9%, p=0.800). The post operative complication rate between the two groups did not show significant difference (5.9% vs. 3.6%, p=0.356), and there was no case of ureteral orifice obstruction or DJ stent insertion after resection the bladder orifice.

Conclusion
There was no significantly difference of upper tract recurrence whether bladder tumor locates near orifice or not. Therefore, it would be safe when we resect the bladder tumor locates near orifice, with no more complication than other site.
keywords : Bladder cancer, ureteral orifice, recurrence

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