膀胱癌侵及前列腺与膀胱癌伴偶发前列腺癌的临床特点及预后比较

Bladder cancer infiltrating prostate and bladder cancer co-existing with incidental prostate caner in men after radical cystectomy: a prognostic analysis

目的比较膀胱癌侵及前列腺患者和膀胱癌伴偶发前列腺癌患者的临床特点与预后情况。方法回顾性分析71例行根治性膀胱切除术的肌层浸润性膀胱癌患者的临床资料,将患者分为两组,A组为膀胱癌侵及前列腺患者33例,B组为膀胱癌伴偶发前列腺癌患者38例。对两组术后预后情况进行分析。结果与B组比较,A组癌症特异性生存率明显缩短(P<0.05)。A组14例(42.4%)、B组8例(22.9%)出现肿瘤复发,两组比较P<0.05。B组Gleason评分4~8(4.8±1.6)分,pT1期11例(28.9%),pT2期24例(63.2%),pT3期3例(7.9%),22例(57.8%)无相关临床症状。共随访10~78(48±19)个月,因膀胱癌进展死亡11例,生化复发2例。结论根治性膀胱切除术后膀胱癌伴偶发前列腺癌通常无相关临床症状,分化良好,预后较膀胱癌侵及前列腺患者好。

Objective To investigate clinical characteristics and prognosis of men who suffered from bladder cancer with incidental prostate caner and bladder urothelial carcinoma invading the prostate after receiving radical bladder cystectomy. Methods We retrospectively analyzed the clinical data of 71 patients who underwent radical bladder cystectomy for muscle invasive bladder cancer and divided them into two groups. Group A included 33 cases of patients with bladder carcinoma invading the prostate and group B contained 38 cases of patients with specimen-found incidental prostate cancer after radical cystectomy. We assessed the postoperative prognosis in the two groups after radical cystectomy. Results Cancerspecific survival was significantly shortened in group A( P = 0. 03). Fourteen patients( 42. 4%) of group A had tumor recurrence and 8 cases( 22. 9%) in group B. Thus,the statistical difference was relatively significant( P = 0. 04). The Gleason score in group B was 4-8,with average score( 4. 8 ± 1. 6). The tumor stage of patients were as follows: pT1 included 11 cases( 28. 9%),pT2 contained 24 cases( 63. 2%) and pT3 involved 3 cases( 7. 9%). Twenty-two cases( 57. 8%) of patients with incidental prostate cancer had no clinical symptoms. The follow-up ranged from 10 to 78 months,average time( 48 ± 19) months. During the follow-up,11 cases died of progress of bladder cancer,and two cases suffered from BCR. Conclusion Patients with incidental prostate cancer after radical bladder cystectomy usually have no relative clinical symptoms and are well-differentiated. Besides,the prognosis of these patients is much better than that of bladder cancer patients with prostate invasion.