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Should men with metastases undergo radical prostatectomy?

机译:转移男性应该接受前列腺癌根治术吗?

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Despite the rarity and clinical heterogeneity of upper tract urothelial carcinoma (UTUC), interest in this disease has increased in recent years. A history of bladder cancer is a known risk factor for the development of UTUC, explaining the widespread inclusion of upper tract imaging modalities, such as CT urography, in surveillance protocols for patients with bladder cancer. To assess the utility of this non-evidence-based approach, Sternberg et al. have now retrospectively studied the risk of developing UTUC in 935 patients with papillary (Ta or Tl) non-muscle-invasive bladder cancer (NMIBC), excluding patients who had been diagnosed with UTUC before (n = 39) or at the time of (n = 22) their bladder cancer therapy. After a median follow-up period of 5.5 years, 51 patients (5.5%) developed UTUC. Of these, only 15 (29%) were detected through routine imaging; the others were diagnosed after developing symptoms. As 3,074 routine CT studies were conducted in total, the overall 'hit rate, for CT urography was just 0.49%. In light of these findings, the authors rightfully concluded that routine CT urography is not useful for the detection of UTUC in patients on surveillance for NMIBC.
机译:尽管上尿路尿路上皮癌(UTUC)罕见且临床上不均一,但近年来对该疾病的兴趣有所增加。膀胱癌的病史是UTUC发生的已知危险因素,解释了在膀胱癌患者的监测方案中广泛包含诸如CT尿路造影的上层成像方式。为了评估这种基于非证据的方法的效用,Sternberg等人。现在已经回顾性研究了935例乳头状(Ta或Tl)非肌肉浸润性膀胱癌(NMIBC)患者的发展为UTUC的风险,但不包括在(n = 39)之前或在( n = 22)他们的膀胱癌疗法。在5.5年的中位随访期后,有51例患者(5.5%)发展为UTUC。其中,仅15例(29%)是通过常规成像检出的。其他人在出现症状后被诊断出。由于总共进行了3,074例常规CT研究,因此CT尿路造影的总“命中率”仅为0.49%。根据这些发现,作者正确地得出结论,常规的CT尿路造影对监测NMIBC的患者中的UTUC没有帮助。

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