保留膀胱综合治疗浸润性膀胱癌的临床研究

Clinical research of comprehensive treatment of invasive bladder cancer with bladder preserved

目的比较保留膀胱的综合治疗与根治性切除术治疗膀胱癌的临床疗效。方法选取T2～3N0～1M0期浸润性膀胱癌患者79例，采用保留膀胱综合治疗（保留膀胱组），并选取同期采用根治性膀胱切除术的膀胱癌患者66例作为对照（根治组），采用Kaplan-Meier法计算生存率、保留膀胱生存率，生存率的组间比较采用Log—Rank检验。结果保留膀胱组术后1、2、3、5年生存率分别为97．5％（77／79）、88．6％（70／79）、70．9％（56／79）、46．8％（37／79），根治组术后1、2、3、5年生存率分别是92．4％（61／66）、86．4％（57／66）、69．7％（46／66）、47．0％（31／66），对两组病例的生存率进行统计学分析，差异无统计学意义（P=0．918）。结论对浸润性膀胱癌病例行保留膀胱综合治疗的生存率与根治性膀胱切除术的生存率相当，值得进一步研究探讨。

Objective To compare the clinical efficacy of bladder preservation for comprehensive treatment and radi-cal cysteetomy for treating bladder cancer.Methods 79 cases with T2-3 N0-1 M0 invasive bladder cancer were given comprehensive treatment with bladder preserved （the bladder preservation group）.Another 66 cases of the same sta-ges were given radical cystectomy as the control group （the radical cystectomy group）.Then, Kaplan-Meier method was used to calculate the survival rate and the survival rate of bladder preservation.Log-Rank was adopted to compare the survival rates between groups.Results The survival rates of the first year,the second year,the third year,and the fifth year after operation in the bladder preservation group were 97.5 % （77/79）, 88.6 % （ 70/79）, 70.9 % （56/79） and 46.8%（37/79） ,respectively.And those of the radical cystectomy group were 92.4% （61/66）,86.4M（57/66）,69.7% （46/66） and 47.0M（31/66）,respectively.There was no statistical significance in the difference of survival rates of the two groups（ P =0.918）.Conclusion Bladder preservation for comprehensive treatment and radical cystectomy result in almost the same survival rates in the treatment of invasive bladder cancer.So it is worthy of further study.