Background:Invasive BC patients are at risk of loco-regional recurrence, distant MTS, and the development of second primary tumors. SPMs comprise the sixth most common group of malignancies.Material and methods:The records of 125 consecutive patients with primary invasive TCC of the bladder seen in the Oncology Department of Soroka University Medical Center were reviewed between January 2016 and December 2023. We recorded demographic details, the type of primary treatment, tumor site, time to diagnosis of MTS, and occurrence of SPMs.Results:The primary treatments included RC in 58 patients (median age 66 years, range 43–86), PC in 9 patients (median age 64 years, range 22–73), and XRT in 23 patients (median age 74 years, range 22–87). Five patients from the PC group were also treated by XRT. A total of 90 (72%) patients developed MTS or SPMs, with 66 of these developing MTS and 24 developing SPMs. The median age was 70 years (range 22–87). The most frequent site of MTS was in the pelvic LNs (34 patients), followed by bone (18 patients), liver (8 patients), and lung (6 patients), with 4 patients developing synchronous MTS in the pelvic LNs and liver. The median time from diagnosis to MTS was 14.3 months. The distribution of MTS varied according to primary treatment. After RC, 17 patients developed LN MTS, 7 liver, 6 bone, and 3 lung MTS. The average times for developing MTS were as follows: LNs, 14.8 months, liver, 59.7 months, bone, 6.8 months, and lung, 16 months. Following XRT, LN MTS developed in 17 patients: 12 bone, 3 lung, and 1 liver. The most frequent SPMs were prostate cancer with 11 patients and lung cancer with 6 patients, with the median time from TCC diagnosis of 54 months.Conclusion:A regular extended follow-up for invasive BC patients is vital to ensure the early detection of frequently occurring MTS and SPMs. Through the early diagnosis of local recurrences, MTS, and SPMs, treatment results and patient prognosis can be significantly improved.
背景：浸润性膀胱癌患者面临局部区域复发、远处转移及第二原发肿瘤发生的风险。第二原发肿瘤在恶性肿瘤中位列第六常见类型。 材料与方法：回顾性分析2016年1月至2023年12月期间索罗卡大学医学中心肿瘤科收治的125例原发性浸润性膀胱尿路上皮癌患者的临床资料。记录患者人口学特征、初始治疗方案、肿瘤部位、转移发生时间及第二原发肿瘤发生情况。 结果：初始治疗包括根治性膀胱切除术（58例，中位年龄66岁，范围43-86岁）、部分膀胱切除术（9例，中位年龄64岁，范围22-73岁）及放射治疗（23例，中位年龄74岁，范围22-87岁）。部分膀胱切除术组中有5例患者联合接受了放射治疗。共有90例（72%）患者发生转移或第二原发肿瘤，其中转移66例，第二原发肿瘤24例，患者总体中位年龄70岁（范围22-87岁）。转移最常见部位为盆腔淋巴结（34例），其次为骨（18例）、肝（8例）和肺（6例），另有4例患者同时出现盆腔淋巴结与肝脏转移。从确诊到发生转移的中位时间为14.3个月。转移分布因初始治疗方案而异：根治性膀胱切除术后，17例发生淋巴结转移，7例肝转移，6例骨转移，3例肺转移，各部位转移平均发生时间分别为淋巴结14.8个月、肝脏59.7个月、骨骼6.8个月、肺部16个月；放射治疗后，17例发生淋巴结转移，12例骨转移，3例肺转移，1例肝转移。第二原发肿瘤中最常见为前列腺癌（11例）和肺癌（6例），自膀胱癌确诊至第二原发肿瘤发生的中位时间为54个月。 结论：对浸润性膀胱癌患者进行规律性长期随访至关重要，有助于早期发现高发的转移及第二原发肿瘤。通过早期诊断局部复发、转移及第二原发肿瘤，可显著改善治疗效果及患者预后。
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