Patterns of metastases and Second Primary Malignancies (SPM) in patients with invasive Transitional Cell Carcinoma (TCC) of the bladder
演題番号 : P25-7
1:Soroka University Medical Center, Israel・Department of Oncology・Onco-Urology Service
Background: Invasive bladder cancer patients are at risk of loco-regional recurrence, distant metastases (mts), and the development of second primary tumors. Second primary malignancies (SPM) comprise the common group of malignancies.
Aim.: To characterize the patterns of metastases and occurrence of second primary malignancies in invasive bladder cancer patients.
Material and methods: The records of 125 consecutive patients (pts) with primary invasive trasitional cell carcinoma (TCC) of the bladder seen in the Oncology Department of Soroka Medical Center and were reviewed. We recorded the type of primary treatment, as well as the site, time to diagnosis of mts and occurrence of SPM.
The primary treatments were: radical cystectomy (RC), 58 pts (median age 66, range 43-86); partial cystectomy,9 pts (median age 64, range 22-73); and radiotherapy (XRT), 23pts (median age 74,range 22-87). Five patients from the partial cystectomy group were treated by XRT. Ninety (72%) pts developed mts or SPM, 66 with mts and 24 SPM.
The median age (years) was 70 (range 22-87).
The most frequent site of mts was in the pelvic lymph nodes (LN)- 34pts, followed by bone- 18pts, liver -8pts, and lung - 6pts, with 4 pts developing synchronous mts in pelvic LN and liver . The median time from diagnosis until mts was 14.3 months. The distribution of mts varied according to primary treatment. After RC 17 pts developed LN mts, 7 -liver mts, 6- bone mts, and 3 lung mts. The average time to developing mts were for LN - 14.8, for liver - 59.7, for bone - 6.8, and for lung -16 months respectively. After XRT LN mts developed in 17pts,12- bone , 3 - lung and 1- liver . The most frequently SPM was prostate cancer: 11 pts (6 diagnosed synchronously, ), and lung cancer- 6 pts (median time from TCC diagnosis 54 months).
Regular extended follow-up is necessary in invasive bladder cancer patients because of the frequent occurrence of metastases.