کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3984932 1601381 2014 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Follow-up after cystectomy: Regularly scheduled, risk adjusted, or symptom guided?: Patterns of recurrence, relapse presentation, and survival after cystectomy
ترجمه فارسی عنوان
پیگیری بعد از عمل جراحی: منظم برنامه ریزی شده، ریسک تعدیل یا علائم هدایت شده ؟: الگوهای عود، ارائه عود، و بقای بعد از عمل جراحی سیتکتکتومی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی تومور شناسی
چکیده انگلیسی

AimsTo evaluate the efficacy of follow-up based on the patterns of recurrence, relapse presentation and survival after cystectomy, and to define a risk adjusted follow-up schedule.Patients and methodsThe records of 343 patients with regular follow-up after cystectomy were reviewed for primary site of recurrence, accompanying symptoms, means of recurrence diagnosis, and clinicopathological factors. Based on Cox proportional hazard models, and the results of imaging studies low and high risk groups are identified and a risk adjusted follow-up protocol is proposed.ResultsThe risk of a recurrence was related to increasing pT, tumour positive lymph nodes, tumour positive surgical margins, and pre-operative dilatation of the upper urinary tract, and low and high risk groups were defined consequently. 84% of all recurrences occurred within 2 years, with only one recurrence beyond 2 years in the low risk group. Although the minority of all patients (34%) is asymptomatic at time of recurrence, symptomatic recurrences were adversely associated with survival. CT-scans and chest X-rays accounted for 90% of the diagnostic tools to detect a recurrence in patients without symptoms.ConclusionsAsymptomatic patients may benefit from early treatment after disease recurrence. A risk adjusted follow-up strategy based on stage of disease and additional clinicopathological factors can dichotomise patients at high and low risk for recurrence. The small benefit in survival after early detection has to be confirmed in future studies, and weighed against the available treatment options of recurrences and their subsequent costs.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Surgical Oncology (EJSO) - Volume 40, Issue 12, December 2014, Pages 1677–1685
نویسندگان
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