Outpatient Holmium laser fulguration: A safe procedure for treatment of recurrence of nonmuscle invasive bladder cancer
| Autor: | G. Hita Villaplana, B. Pietricica, A. Romero Hoyuela, T. Fernández Aparicio, Á. Rivero Guerra, E. Izquierdo Morejón, I. Barceló Bayonas, C. Carrillo George, A. Rosino Sánchez, D. Jiménez Peralta, V. Muñoz Guillermo, A. Pardo Martínez |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Bladder cancer Visual analogue scale business.industry Fulguration Mitomycin C 030232 urology & nephrology Holmium laser General Medicine medicine.disease Resection Surgery 03 medical and health sciences Regimen 0302 clinical medicine 030220 oncology & carcinogenesis medicine Bladder tumor business |
| Zdroj: | Actas Urológicas Españolas (English Edition). 42:309-315 |
| ISSN: | 2173-5786 |
| Popis: | Background and objective Nonmuscle invasive bladder cancer has a high recurrence rate and a low progression rate. The aim of this study was to assess the effectiveness, safety and feasibility of Holmium laser fulguration in an outpatient regimen for selected tumors. Material and method A prospective, longitudinal cohort study was conducted between January 2009 and December 2016. Seventy-nine Holmium laser fulguration procedures with subsequent instillation of mitomycin C were performed in an outpatient regimen on 59 patients with a history of low-risk bladder cancer and recurrence of small papillary tumors. We performed a descriptive data analysis and analyzed the relapse-free time using Kaplan–Meier curves. Results All procedures were completed in one day, and only one patient required subsequent hospitalization due to haematuria. Some 87.2% of the patients presented pain with a visual analog score ≤3. Recurrence occurred after 49.4% of the procedures (27.3% at 12 months). The median follow-up time was 17 months (range, 2–65). The onset of recurrence was significantly earlier after the second fulguration than after the first (median, 10 months vs. 56 months). Conclusions Holmium laser fulguration and subsequent mitomycin C instillation in an outpatient regimen is a safe and feasible alternative to transurethral resection of bladder tumors in selected patients. Transurethral resection of the bladder tumor is recommended for patients with recurrence after fulguration, given the possibly higher risk of progression in these patients. |
| Databáze: | OpenAIRE |
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