浸润性膀胱癌保留膀胱的综合治疗疗效评价

Therapeutic effect of bladder preservation in the treatment of muscle invasive bladder cancer

目的评价肌层浸润性膀胱癌（MIBC）保留膀胱的综合治疗疗效。方法收集本院2003年1月-2010年8月MIBC病例72例,根据治疗方式,其中保留膀胱组42例,根治性膀胱切除组30例。保留膀胱组采用膀胱部分切除或经尿道膀胱肿瘤切除（TURBt）,结合放化疗。通过门诊及电话等方式随访,应用Kaplan-meier法和Log-rank检验,比较两组生存情况。结果随访患者56例,随访率78%。患者随访12-92个月,平均随访43.1个月,中位随访时间为50个月。随访期间,死于膀胱癌者34例,保留膀胱组21例（50%）,根治性膀胱切除组13例（43%）。术后1、2、3、4、5年生存率保留膀胱组分别为88.1%、83.3%、61.9%、57.1%、47.6%,根治性膀胱切除组分别为86.7%、80.0%、66.7%、63.6%、53.3%。两组间差异无统计学意义。结论 MIBC采取保留膀胱的综合治疗可达到与根治性膀胱切除相似的生存率。

ObjectiveTo evaluate the therapeutic effect of bladder preserving in the treatment of muscle invasive bladder cancer（MIBC）.MethodsClinical data of 72 patients with MIBC from January 2003 to August 2010 in our hospital were analyzed, including 42 cases of MIBC underwent partial cystectomy or TURBt combined with chemotherapy or radiotherapy, and 30 cases underwent radical cystectomy. Kaplan-meier method and Log-rank test were used to analyze overall survival.ResultsDuring the follow up 12-92 months（mean 43.1 months）, 34 patients died,including 21 cases （50%） underwent bladder-preserving treatment and 13 cases（43%） underwent radical resection. The survival rate of bladder -preserving treatment group after 1, 2, 3, 4, 5 year were 88.1%, 83.3%, 61.9%, 57.1%, 47.6%, respectively, and the radical resection group were 86.7%, 80.0%, 66.7%, 63.6%, 53.3% respectively. There was no significant difference between the two groups（P〉0.05）. ConclusionBladder-preserving treatment in MIBC can reach a similar survival rate with radical cystectomy.