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1 Tishreen University Journal for Research and Scientific Studies - Medical Sciences Series Vol. (3) No. (٣) T3 T4 T2 T1 Ta TUR G3 G2 G1 * ٩

2 27 2 Tishreen University Journal for Research and Scientific Studies - Medical Sciences Series Vol. (3) No. (٣) 28 Experience of Al-Asad University Hospital, Lattakia, in the Management of Bladder Cancer during 2-27 Dr. Mohammad Youssef (Received 23 / 4 / 28. Accepted 21/7/28) ABSTRACT The trial included patients(2males,8females) with bladder cancer (mean age: 62. years).the majority were chain smokers (7%). They suffered hematuria (1%) and voiding obstructive symptoms (7%). They were diagnosed by cystoscopy. We noticed a small tumor in 8% and multiple tumors in %. There were Ta, T1, T2, T3 and T4 in 36%, 31%, 2%, 6.6%, respectively. There were G1, G2, G3 in 38%, 43%, 18% ;respectively. The TUR BT was performed in 66% of the cases with intravesical adjuvant chemotherapy, and the radical cystectomy was performed for 28% and in 3% of cases we performed a partial cystectomy. The Ureterosigmoidostomy was performed for 7 patients, and the orthotropic urinary diversion was performed in 6 cases. The Cutaneous Ureterostomy was performed for 2 patients and we performed a1continent Cathaterizable Reservoir and a 1 Bricker's procedure. Keywords: Bladder Cancer, TUR, Intravesical Adjuvant Therapy, Urinary Diversion * Professor, Department of Surgery, Faculty of Medicine, Tishreen University, Lattakia, Syria. ٠

3 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series CT Scan C.E.A O,B,A Cytology carcino embryonic antigene 4 amino-biphenyl 4 Beta-naphtylamine Benzidine 4- nitro-biphenyl Transitional cell carcinoma B. C. G 3 6 ١

4 % ٢

5 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series % > العمر < ٣

6 27 2 H 42 7 M 1 2 L/N H M L/N :Hematuria Urinary tract infection Lower urinary tract obstruction ٤

7 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series بیلة دمویة Echograph Diagnosis I. V.P Intra-venous Pyelography ultrasound 1 Cystoscopy Hydronephrosis 3 CT - scan IVU CT - Scan IVU CT - Scan Echo مثانة ٥

8 ٦

9 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series متعدد [ ] Stage Ta T T T3 T4 4 T3 - T4 T2 T1 Ta CIS ٧

10 T3 - T4 T2 T1 Ta CIS Papillary transitional cell carcinoma GradeI : G 1 GradeII : G2 GradeIII : G3 G2 adeno carcinoma Non popillary transitional cell concinoma G3 Grade G G G ٨

11 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series G3 G2 G1 Transurethral Resection of the Tumor ( T.U.R) Partial Cystectomy 3.33 Radical Cystectomy Urinary Diversion 1.66 TUR ٩

12 TUR Adjuvant therapy Intravesical Chemotherapy D1 D et D ٠

13 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series Mainz [ ] carcinoma in situ Treatments A [ ] recurrence sessile tumors papillary tumors ١

14 27 2 Thiotepa [ ] Thiotepa adriamycine [ Doxorubicine 2 ] Radical Cystectomy 16 Bleomycine (B.C.G fluracil partial Carcinoma in situ cystectomy Metastasis 2 1 ٢

15 مجلة جامعة تشرین العلوم الصحیة المجلد (٣٠) العدد (٣) ٢٠٠٨ Tishreen University Journal. Med. Sciences Series 1. SOBIN,D ; WITTEKIND,C ; EDS. P In: TNM classification of malignant tumours.6thedn.newyorkwiley-liss, EBLE, J; SAUTER,G; EPSTEIN,J; SESTERHENN, I; EDS. WHO classification of tumours of the urinary system and male genital organs.lyon: IARCC Press, VAN DER MEIJDEN, A; SYLVESTER, R; OOSTERLINCK, W; SOLSONA, E; BOEHLE, A; LOBEL, B; RINTALA, E. for the EAU Working Party on Non Muscle Invasive Bladder Cancer EAU guidelines on the diagnosis and treatment of urothelial carcinoma insitu. EurUrol,2,48, SYIVESTER,R; VANDERMEIJDEN,A ; OOSTERLINCK, W; WITJES, A; BOUFFIOUX, C; DENIS,L; NEWLING, D; KURTH, K. Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables: a combined analysis of 296 patients from seven EORTC trials. Eur Urol,26,49, AVEYARD, F; ADAB, P; CHENG, K; WALLACE, D; HEY, K; MURPHY, M. Does smoking status influence the prognosis of bladder cancer? A systematic review. BJU Int 22,9, BRAUSI, M; COLLETTE, L; KURTH,K; VAN DER MEIJDEN, A; OOSTERLINCK, W; WITJES, J; NEWLING, D; BOUFFIOUX,C; SYLVESTER,R; EORTC Genito- Urinary Tract Cancer Collaborative Group. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta Ti transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol 22,41, JAKSE,G; ALGABA, F; MALMSTROM,P; OOSTERLINCK,W. A second-look TUR in Ti transitional cell carcinoma: why? Eur Urol 24,4, BRAUERS,A; BUETTNER, R; JAKSE, G. Second resection and prognosis of primary high risk superficial bladder cancer: is cystectomy often too early? J Urol 21,16, ODDENS, J; VAN DER MEIJDEN, A; SYLVESTER,R. One immediate postoperative instillation of chemotherapy in low risk Ta, Ti bladder cancer patients. Is it always safe? Eur Urol 24,46, NOMATA, K; NOGUCHI,M; KANETAKE, M; TSUDA, N; HAYASHI,M; YAMASHITA,; SAKURAGI,T; KUSABA, Y; SHINDO, K; NAGASAKI Clinical Research Group for Bladder Cancer Intravesical adjuvant chemotherapy for superficial transitional bladder cancer: results of a randomised trial with epirubicin comparing short and long-term maintenance treatment. Cancer Chemother Pharmacol 22,, KOGA, G; KUROIWA,K; YAMAGUCHI,A; OSADA,Y; TSUNEYOSHI, M; NAITO,S. A randomized controlled trial of short- term versus long-term prohylactic intravesical instillation chemotherapy for recurrence after transurethral resection of Ta/Ti transitional cell carcinoma of the bladder. J Urol 24,1 71, KURODA,M; NHJIMA, T; KOTAKE,T; AKAZA, H; HINOTSU, S; 6th Trial of the Japanese Urological Cancer Research Group. Effect of prophylactic treatment with intravesical epirubicin on recurrence of superficial bladder cancer - The 6th Trial of the Japanese Urological Cancer Research Group (JUCRG): a randomized trial of intravesical epirubicin at dose of 2Omg/m1, 3 mg/ ml, mg/ ml. Eur Urol 24,4,-. ٣

16 HUNCHAREK; KUPELNICK,B. Impact of intravesical chemotherapy versus BCG immunotherapy on recurrence of superficial transitional cell carcinoma of the bladder. Am J Clin Oncol 23,26, MILLAN-RODRIGUEZ, F; CHECHILE-TONIOLO,G; SALVADOR-BAYARRI, J; PALOU,J; VICENTE-RODRIGUEZ,J. Multivariate analysis of the prognostic factors of primary superficial bladder cancer. J Urol 2,1 63, LAMM, D; BLUMENSTEIN,B; CRISSMAN,J; MONTIE, J; GOTTESMAN,J; LOWE, B; SARASODY,M; BOHL,R; GROSSMAN,H; BECK, T; LEIMERT, J; CRAWFORD, E. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent Ta, Ti and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study J Urol 2,i63,ii24-ii OGE, ; ERDEM, E; ATSU, N; AHIN, A; OZEN, H. Proposal for changes in cystoscopic follow-up of patients with low-grade pta bladder tumor Eur Urol 2,37, FUJN,Y; KAWAKAMI, S; KOGA,F; NEMOTO,T; KIHARA, K. Long-term outcome of bladder papillary urothelial neoplasms of low malignant potential. BJU Int. 23,92, BORHAN, A; REEDER,J; O CONNELL, M; WRIGHT,K; WHEELESS, L; DI SANT AGNESE, P; MCNALLY, M; MESSING, E. Grade progression and regression in recurrent urothelial cancer. J Urol 23,169, ZIETMAN, A; SHIPLEY, W; KAUFMAN,D. Organ-conserving approaches to muscle invasive bladder cancer: future alternatives to radical cystectomy. Ann Med 2,32, HOLMANG, S; HEDELIN,H; ANDERSTROM, C; JOHANSSON,S. Long-term followup of all patients with muscle invasive (stages T2, T3 and T4) bladder carcinoma in a geographical region. J Urol 1997,1 8, MANSSON, A; MANSSON, W. When the bladder is gone: quality of life following different types of urinary diversion. World J Urol 1999,17, ٤

Clinical significance of immediate urine cytology after transurethral resection of bladder tumor in patients with non-muscle invasive bladder cancer

International Journal of Urology (2011) 18, 439 443 doi: 10.1111/j.1442-2042.2011.02766.x Original Article: Clinical Investigationiju_2766 439..443 Clinical significance of immediate urine cytology after