Bladder Cancer

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Bladder Cancer
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• 1.Incidence and Prevalence
• 0.828/10?(men)
• 0.27/10? (female)
• Occupational exposure
• ??????????????--????????????????????
• ?????????????????????????????????????????
  
• Cigarette smoking
• ???????????????
• Chronic cystitis and other infections
• ??????????????????????????

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2.Pathology

• 1.Type of Histology
• transitional cell carcinoma 90
• spuamous cell carcinoma 7
• adenocarcinoma 2
• urachal carcinoma

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2.????WHO G1 ???
G2 ??? G3 ???

• 3.Spread metastatic spread
• lymphatic spread
• vascular spread
• -liver 38
• -lung 36
• -bone 27

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4.Staging
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5.Natural history

• 1.????????????80
• (intermittent painless hematuria)
• 2.????????
• (frequency,urgency,pain)
• 3.???? ????
• (dysuria,bladder stone)
• 4.????? ?? ?? ????

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6.Diagnosis

• 1.signs and symptoms
• 2.physical examination
• 2.microscopic cytology
• ???? ???7080
• ???????
• ????????
• BTA

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Diagnosis

• 3.Cystoscopy
• sharp ?site ?amount ?size?biopsy ?relationship
• ???????????
• Ta T1?????,???,???,??
• T2 T3????,??,?????,
• T3 T4??,????,????,????
• ????,?????,??,???
• ????
• ???????????????????
• ??

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Diagnosis

• 4.X-ray Excretory Urography(IVU)
• ?????????(?????)
• ??????
• ??????????
• ????????
• 
  ?????--??????
• 5.Computed Tomography(CT)
• ?????????
• ??????????????

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Diagnosis

• 6.MRI
• 7.Ultrasonography

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7.Treatment

• ??(resection)
• ??(radiation therapy)
• ??(chemotherapy)
• ????(biologic therapy)
• Principlesuperficial(Tis,Ta,T1)
• ----??????
• invasive and
  regional(T2,T3,T4)
• ----??????

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7.Treatment

• 1. superficial(Tis,Ta,T1)--??
• ??????(Transurethral resection
• TUR-BT)
• ?????????
• ????(laser therapy)
• ??(follow-up)?3???????

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7.Treatment

• 2. invasive and regional(T2,T3,T4)--??
• (1). partial cystectomy
• Indication ???????3cm??,TUR??????,????
• Anti-indication??,??,???????,??????
• ?????????2cm,???
• (2). total cystectomy
• ????,???,??,????
• indication?????,?????????,????,?????????????

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7.Treatment

• radiation
• ?? radiation cystitis
• chemotherapy
• ????????????
• ????
• ?????(thiotepa)
• ????(mitomycin)
• ???(doxorubicin)

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7.Treatment

• Biologic therapy
• Bacille Calmette-Guerin (BCG)
• ????(side-reaction)
• ???(cystitis )
• ??(hematuria)
• ??(tetter)
• ????(bladder spasm)
• ???(interferon)
• ???-2(Interleukin-2)

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8.Follow up

• Superficial tumor initial resection
• tumor free recurrent
• 2 years-------43
• 5 years-------22
• Bladder washing
• Cystoscopic examination

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Neoplasms of the Testis
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1. etiology

• Incidence---3.7 per 100,000 (USA 1971)
• ??(cryptorchidism) 5-10
• ??(genetic factors) 2-3
• ??(trauma)
• ??(atrophy)

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2.pathogeny

• ??(Primary neoplasms)
• ??????(germinal neoplasms)
• ?????(seminoma)
• ???(embryonal carcinoma)
• ???(teratoma)
• ??????(choriocarcinoma)
• ???????(nongerminal neoplasms)
• ??????(gonadal stromal
  neoplasms)
• ??(Secondary)
• ?????(metastases)

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3. Clinical Manifestations

• A nodule or painless swelling or harden of one
  gonad
• In approximately 10 of patients,acute pain is
  the presenting symptom
• In approximately 10 of patients,metastases
  symptom is the present

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4.Diagnosis

• History
• Physical examination
• Lab examination
• ultrasonography
• ??(tumor markers)
• a-FP () ???
• hCG () ?????
• ??????

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5.Treatment

• Surgery (early radical orchiectomy ???????)
• Seminoma(?????)
• radical orchiectomyradiation therapy?
• embryonal carcinoma(???)
• radical orchiectomy retroperitoneal
  lymphadenectomy(?????????)
• Choriocarcinoma(??????)
• radical orchiectomy chemotherapy

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