国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
International Journal of Urology and Nephrology
2015年
6期
801-804
,共4页
膀胱肿瘤%膀胱切除术%预后
膀胱腫瘤%膀胱切除術%預後
방광종류%방광절제술%예후
Urinary Bladder Neoplasms%Cystectomy%Prognosis
目的 探讨选择性膀胱部分切除术(PC)联合膀胱灌注化疗治疗肌层浸润性膀胱癌(MI-BC)疗效及预后影响因素.方法 回顾性收集本院收治的55例肌层浸润性膀胱癌患者临床资料,所有患者均接受PC联合膀胱灌注化疗治疗,并进行随访观察5年癌特异性生存率、总生存率和复发率,先采用单因素分析5年癌特异性生存率的可能影响因素后行多因素Logistic回归分析.结果 55例患者随访时间10 ～ 60个月,中位随访时间44个月,5年癌特异性生存率、总生存率和复发率分别为72.73％(40例)、61.82％(34例)和30.91％(17例);x2检验显示,年龄≥60岁、T3分期、有膀胱肿瘤史、肿瘤多发、肿瘤≥5cm患者5年癌特异性生存率显著降低,而联合输尿管再植术(UR)治疗患者5年癌特异性生存率显著升高,差异均有统计学意义(P＜0.05);多因素Logistic回归分析显示,肿瘤≥5cm,肿瘤多发,T3分期是肌层浸润性膀胱癌预后的危险因素,会降低癌特异性生存率,而联合UR治疗则是其保护因素,能增加癌特异性生存率.结论 PC联合膀胱灌注化疗是治疗MIBC可行的保留膀胱术式,联合UR治疗可以改善预后,而肿瘤≥5cm、多发以及T3分期的患者5年癌特异性生存率明显降低,不推荐行保留膀胱手术.
目的 探討選擇性膀胱部分切除術(PC)聯閤膀胱灌註化療治療肌層浸潤性膀胱癌(MI-BC)療效及預後影響因素.方法 迴顧性收集本院收治的55例肌層浸潤性膀胱癌患者臨床資料,所有患者均接受PC聯閤膀胱灌註化療治療,併進行隨訪觀察5年癌特異性生存率、總生存率和複髮率,先採用單因素分析5年癌特異性生存率的可能影響因素後行多因素Logistic迴歸分析.結果 55例患者隨訪時間10 ～ 60箇月,中位隨訪時間44箇月,5年癌特異性生存率、總生存率和複髮率分彆為72.73％(40例)、61.82％(34例)和30.91％(17例);x2檢驗顯示,年齡≥60歲、T3分期、有膀胱腫瘤史、腫瘤多髮、腫瘤≥5cm患者5年癌特異性生存率顯著降低,而聯閤輸尿管再植術(UR)治療患者5年癌特異性生存率顯著升高,差異均有統計學意義(P＜0.05);多因素Logistic迴歸分析顯示,腫瘤≥5cm,腫瘤多髮,T3分期是肌層浸潤性膀胱癌預後的危險因素,會降低癌特異性生存率,而聯閤UR治療則是其保護因素,能增加癌特異性生存率.結論 PC聯閤膀胱灌註化療是治療MIBC可行的保留膀胱術式,聯閤UR治療可以改善預後,而腫瘤≥5cm、多髮以及T3分期的患者5年癌特異性生存率明顯降低,不推薦行保留膀胱手術.
목적 탐토선택성방광부분절제술(PC)연합방광관주화료치료기층침윤성방광암(MI-BC)료효급예후영향인소.방법 회고성수집본원수치적55례기층침윤성방광암환자림상자료,소유환자균접수PC연합방광관주화료치료,병진행수방관찰5년암특이성생존솔、총생존솔화복발솔,선채용단인소분석5년암특이성생존솔적가능영향인소후행다인소Logistic회귀분석.결과 55례환자수방시간10 ～ 60개월,중위수방시간44개월,5년암특이성생존솔、총생존솔화복발솔분별위72.73％(40례)、61.82％(34례)화30.91％(17례);x2검험현시,년령≥60세、T3분기、유방광종류사、종류다발、종류≥5cm환자5년암특이성생존솔현저강저,이연합수뇨관재식술(UR)치료환자5년암특이성생존솔현저승고,차이균유통계학의의(P＜0.05);다인소Logistic회귀분석현시,종류≥5cm,종류다발,T3분기시기층침윤성방광암예후적위험인소,회강저암특이성생존솔,이연합UR치료칙시기보호인소,능증가암특이성생존솔.결론 PC연합방광관주화료시치료MIBC가행적보류방광술식,연합UR치료가이개선예후,이종류≥5cm、다발이급T3분기적환자5년암특이성생존솔명현강저,불추천행보류방광수술.
Objectives To explore the efficacy and affecting factors of muscle-invasive bladder cancer (MIBC) patients treated by partial cystectomy (PC) combined with bladder perfusion chemotherapy.Methods To retrospectively collect the clinical data of 55 cases MIBC patients from hospital secondly uropoiesis surgical department,and all patients were treated by PC combined with bladder perfusion chemotherapy,observed with the 5 years cancer specific survival,overall survival and relapse rate,selected the potiential influence factors of 5 years before cancer specific survival using the single factor analysis,then used the logistic regression analysis.Results The follow-up time was 10 to 60 months,the median follow-up time was 44 months,the 5 years cancer specific survival,overall survival and relapse rate were respectively 72.73％ (40 cases) 、61.82％ (34cases) and 30.91％ (17cases),x2 test showed that petients whose age ≥ 60,T3 stage,had a history of bladder tumor,multiple tumor,tumor ≥ 5 cm,their 5 years cancer specific survival significantly reduced,and combined with ureteral reimplantation (UR) treatment the 5 years cancer specific survival significantly rised,the difference had statistical significance (P ＜ 0.05);Multiariable Logistic regression analysis showed that tumor ≥5 cm,multiple tumor,muscular T3 stage were risk factors for invasive bladder cancer prognosis,they could reduce cancer specific survival rate,and combined therapy with UR was its protection factor,it could increase cancer specific survival.Conclusions PC combined with bladder perfusion chemotherapy is a feasible retention bladder surgery on treating MIBC,combined with UR treatment can improve prognosis,and the 5 years cancer specific survival in patients with tumor≥5 cm,multiple and T3 stage are decreased obviously,we will not reconmended preserve bladder surgery.
