1995 Volume 34 Issue 4 Pages 773-779
Evaluation of the response of patients to various treatment methods and follow-up to detect recurrence are important in the management of bladder cancer. Urinary cytology is useful in achieving these purposes and can be performed repeatedly because of less distress to the patients and the ease of sampling. The efficacy of urinary cytology in evaluating treatment and following up patients with bladder cancer was assessed.
Classification of response to treatment was performed using the radiotherapy criteria response for cancer of the cervix (Moriwaki et al.). Responses were classified from RO (non-effective) to R, (complete response) according to the degree of degeneration and diminution of cancer cells.
The subject of this study was 43 bladder cancers (42 TCCs and 1 SCC). The total number of samples was 428 (average: 10 samples/case). There were 3 G 1 cases, 29 G 2, 9 G 3, 1 GX, 8 pTis (CIS), 2 pTa, 7 pT 1, 1 pT 2, 2 pT 4, and 22 pTX.The pTis (CIS) patients were treated by intravesical instillation of anti-cancer drugs and BCG, pT 1 patients by transurethral resection, and advanced cases by partial or total cystectomy with adjuvant therapy.
Reports to clinicians of response grading by urinary cytology seem useful in improving the efficacy of the treatment of bladder cancer. Response to treatment of CIS be could judged by urinary cytology alone. Using this methods, necessity of continued treatment and early detection of recurrence of bladder cancer are possible, and recurrence of ladder cancer was detected in 9 cases within the follow-up period of the study. The viability of cancer cells and differentiation between cancer cells and reactive atypical cells are discussed.
