Bladder cancer patients who once failed BCG vaccine, should:
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
Correct Answer :
C. take a second course of BCG
for patients who have failed BCG, a second course results in 30% to 50% response rate. Quinolones should not be given with BCG.
Related Questions
Once muscle invasion is detected in bladder cancers, what percentage of occult metastasis is expected?
30%
40%
50%
60%
What is the commonest type of tumors occurring in the penile urethra?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
Which of the following is a risk factor for developing upper urinary tract tumors?
obesity
consuming artificial sweeteners
asbestosis
analgesic abuse
Which of the following statements concerning lymphatic drainage of the male urethra is true?
the anterior urethra drains into the inguinal and pelvic nodes
the posterior urethra drains into the pelvic nodes
the proximal two-thirds drain into the external and internal iliac nodes
the distal one-third drains into the obturator nodes
In what percentages do upper tract urothelial tumors develop in patients with a bladder urothelial cancer?
2 - 4%
4 - 6%
6 - 8%
8 - 10%
What is the likelihood that inverted papillomas of the upper urinary tract accompany tumors?
never
unlikely
likely
always
Risk factors for recurrence and progression of bladder cancers include the following:
multifocality
high tumor grade and advanced stage
presence of CIS
all of the above
During women`s life span, what percentage of women will develop keratinizing squamous metaplasia of the bladder?
10%
20%
30%
40%
Common benign urethral tumors include all of the following,
EXCEPT:
leiomyoma
hemangioma
fibroepithelial polyp
lymphangioma
In what percentages of patients do bilateral upper tract tumors occur either synchronously or metachronously?
0.6 - 2%
2 - 6%
6 - 10%
12 - 16%
What gene mutation is common in carcinoma-in-situ of urinary bladder?
RB
cyclin A
HRAS
CD-44
What is false regarding the symptomatology of urethral cancers?
obstructive LUTS are common presentations and occur in association with carcinoma in situ
might present as perineal abscesses and fistulae
could be asymptomatic
venereal diseases increase the risk of urethral cancers
The most significant prognostic factors for survival in female urethral cancers are:
sensitivity to chemotherapy and age at presentation
anatomic location and extent of the tumor
histologic type of the tumor and sensitivity to radiotherapy
tumors stage and grade
What is the commonest manifestation of upper tract urothelial carcinomas?
obstructive uropathy
painless hematuria
pain radiating to the groin
locally advanced tumor
For radical cystectomy, thromboembolism prophylaxis is required:
immediately before operation
immediately before incision and post-operative for 1 day
immediately before incision and post-operative for 15 days
immediately before incision and post-operative for 30 days
Bladder tumors with hydronephrosis are:
often of high-grade sarcomas
often associated with muscularis propria invasion
due to vesical polyps occluding ureteric orifices
should be resected but not diathermized
What percentage of bladder cancers is squamous cell type in origin?
2%
5%
70%
90%
In women, what is the commonest type of cancers occurring in the proximal urethra?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
What is false concerning upper tract urothelial tumors?
rarely diagnosed at autopsy
the peak incidence occurs between ages 70 and 80
they occur twice as frequently in men as in women
none of the above
The treatment of T2/Nx/M0 prostatic urethral cancer is:
en bloc resection involving total penectomy, cystoprostatectomy, resection of the pubic rami and urogenital diaphragm, with pelvic lymphadenectomy. In addition, creating a urinary diversion.
total penectomy involving removal of the penis, urethra, and penile root
partial penectomy involving excision of the malignant lesion with 2-cm margins
transurethral resection or fulguration
What is the commonest type of tumor occurring in urethral diverticuli?
adenocarcinoma
transitional cell carcinoma
squamous cell carcinoma
basal cell carcinoma
What is the most common sarcoma of the bladder?
leiomyosarcoma
rhabdosarcoma
carcinosarcoma
neurosarcoma
Which of the following does NOT predispose to bladder cancer?
working with organic chemicals and dyes
abuse of pain-control medications especially phenacetin
exposure to arsenic and aromatic amines
schistosomiasis
Regarding ureteral cancers, what is the commonest part of tumor development?
upper ureter
middle ureter
lower ureter
comparable
What is the imaging modality of choice in the evaluation of a suspected urethral cancer?
ascending urethrography
voiding cystourethrography
MRI
IVU
What might occur while resecting a bladder mass at the posterolateral wall?
bladder perforation
obturator nerve reflex
vesico-ureteral reflux
terrible bleeding
Carcinoma-in-situ of the prostatic urethra mostly occurs at the:
mid prostate to the verumontanum at the 5 and 7 oclock positions
lateral margins of the prostate at the 10 and 2 oclock positions
entire area distal to the urethral crest
area between ejaculatory duct openings and prostatic utricle
The treatment of nonmuscle-invasive bladder cancer begins with:
single intravesical chemotherapy
TURBT
intravesical BCG vaccine
multiple bladder biopsies
Bladder cancer patients who once failed BCG vaccine, should:
undergo cystectomy
try mitomycin c
take a second course of BCG
take a second course of BCG + quinolones
Concerning upper tract urothelial tumors, what is the single most important predictor of outcome?
tumor stage
tumor grade
lymphovascular invasion
lymph node spread