Dissertation for the degree of Doctor of Medicine (MD)
Abstract:
Introduction: Bladder cancer is the second most common urological malignancy and the fourth cause of cancer-related death. Considering the high prevalence and high rate of tumor recurrence and since there is no comprehensive statistics and information about the prevalence of bladder cancer and disease recurrence in our country, we investigated this issue in this study.
Method of implementation: In this retrospective study, the files of 233 patients diagnosed with bladder cancer who were admitted to Kamkar Hospital between 1384 and July 1390 were examined. The patients were subjected to various treatments such as T.U.R., immunotherapy, chemotherapy and surgery. In this study, the patients were evaluated in terms of age, sex, smoking, clinical symptoms and the rate of recurrence after treatment.
Results: Out of 233 patients with bladder tumor, 84% were male and 16% were female. Also, the frequency of smoking is 74% in men and 34% in women; The average age of the affected population is 63.87 years (minimum 19 years and maximum 98 years). The most common symptom of the disease is hematuria. Also, the overall recurrence rate of the disease was 61.9%, among those who received BCG, this rate was 73.6%, and among those who underwent chemotherapy after TUR, the recurrence rate was 75%.
Discussion and conclusion: The prevalence of bladder tumors was higher in men than in women. In addition, the age of the outbreak is also lower than the existing reports. 74% of the affected men were smokers, which is a figure and also the rate of disease recurrence is higher than the values ??of global reports, therefore it requires more attention from doctors to the effectiveness of treatment and also more attention from patients to proper follow-up of the disease.
Key words: bladder tumor - risk factor - TUR-BCG - chemotherapy
Introduction:
During the studies conducted in the field of bladder cancer prevalence, recurrence and progression, the rate of disease recurrence after TUR-B treatment is higher compared to the case where intravesicle supplemental treatment is used after TUR-B. This rate of increase also applies to the progression of the disease.
Since in our country there are no statistics and comprehensive information about the prevalence of bladder cancer and the recurrence and progression of the disease after treatment, accordingly, considering the high prevalence as well as the ease of diagnosis and treatment of these patients and the high rate of tumor recurrence, we decided to conduct a study on patients who were diagnosed with bladder cancer during the years 1384 to July 1390 in the hospital. Kamkar has been hospitalized; To check the rate of recurrence.
In this project, the information of hospitalized patients who underwent TUR-B (Transurethral resection of bladder tumor) surgery was collected and analyzed. This information includes: age, gender, clinical symptoms, tumor size, tumor stage. According to the results of the review of the files, the follow-up of the patients has also been examined.
Research objectives:
The main goal of the project:
Investigating the effect of TUR-B treatment on patients with bladder tumors
The secondary goal of the project:
Determining the age distribution of patients with bladder cancer
Determining the recurrence rate of bladder tumor after TUR-B
Determining the prevalence of symptoms in patients referred with bladder tumor
Investigating the sexual prevalence in bladder cancer patients
Investigating the recurrence rate after BCG treatment in patients with bladder cancer
Evaluation of the rate of recovery with chemotherapy drugs in recurrence after TUR-B in patients with bladder cancer
Chapter Two:
Knowledge available in the research
conceptual framework:
Bladder cancer is the second most common cancer of the urinary-genital system. The ratio of men to women in this cancer is 2.7 to 1. The average age of patients when the disease is diagnosed is 65 years. At this time, about 85% of cases are limited to the bladder, and 15% of them have spread to regional lymph nodes or distant areas.
People who smoke a lot have a higher chance of developing bladder cancer, so that about 50% of male smokers have the possibility of developing bladder cancer, and this amount reaches 31% in female smokers. Occupational factors are also important in the development of bladder cancer, such as paint and rubber, painting, oil and leather industry workers who are more susceptible to the disease due to the presence of carcinogenic substances in the aforementioned industries, which include: benzidine, butanephthylamine, 4-aminobiphenyl, cyclophosphamide, artificial sweeteners, physical trauma of the urothelium (due to infection, stone or manipulation) among other factors that are known to cause bladder cancer.
It seems that genetic factors are also involved in the development of bladder cancer, including the absence of some factors on chromosome number 9, deletion of chromosome q11, increased production of C-Ha-ras protein, which is a product of p21, and deletion of chromosome 17p. But the most common chromosomal disorder known in bladder cancer is p23 mutation, which can lead to muscle invasive cancer. Retinoblastoma gene is also present in bladder cancer. The TNM system is used to determine the stage of bladder cancer.
Abstract:
Introduction:
Bladder cancer is the second most common urological malignancy and the fourth leading cause of death from cancer. Because of the high prevalence and recurrence, and since there wasn't enough data on the incidence and recurrence of bladder cancer in IRAN, we are encouraged investigating the case.
Methods:
In this retrospective study, the records of 233 bladder cancer patients since Iranian calendar; 1384 to Tir 1390 admitted in Kamkar Hospital are assessed. The patients have been treated with various treatments such as: TURB, immunotherapy, chemotherapy and surgery.
In this study the patients are categorized based on their age, sex, smoking status, and clinical relapse rates after treatment.
Results:
From 233 cases of bladder cancer patients, 81.5% are male and 18.5% are female. Seventy four percent of men and 34% of women are smokers. The mean age of the population was 63.87 years (range 19-98). The results indicate that hematuria is the most common symptom and the overall recurrence rate is 61.9%. The clinical relapse for patients treated by BCG is 73.6% and for those who received chemotherapy after TUR is 75%.
Discussion:
This article shows that the incidence of bladder tumors in males is higher than females. Moreover, the prevalent age is lower than the one that has already been reported.