高级别T1膀胱癌术后肿瘤复发与进展的相关影响因素

The influencing factors of recurrence and progression of high-grade T1 bladder cancer after bladder-sparing surgery

目的探究高级别T1膀胱癌保留膀胱术后肿瘤复发与进展的相关影响因素。方法回顾分析2013年1月至2016年12月在武汉大学中南医院泌尿外科接受保留膀胱手术治疗的87例高级别T1膀胱尿路上皮癌患者的临床资料。随访术后2年内肿瘤复发及进展情况,并行Cox回归分析研究相关影响因素。结果87例患者均获得2年随访,术后2年内共有55例(63.21%)肿瘤复发,24例(27.59%)肿瘤进展。Cox回归分析结果显示,肿瘤大小、肿瘤数目、是否初发、膀胱灌注方案是影响高级别T1膀胱癌术后肿瘤复发的独立因素(P<0.05);肿瘤大小、肿瘤数目、是否合并原位癌是影响高级别T1膀胱癌术后肿瘤进展的独立因素(P<0.05)。结论临床工作中高级别T1膀胱癌应结合患者肿瘤大小、肿瘤数目、是否合并原位癌、是否初发等情况综合考虑治疗方案。

ObjectiveTo explore factors influencing the recurrence and progression of high-grade T1 bladder cancer after bladder-sparing surgery.MethodsThe clinical data of 87 cases of high-grade T1 bladder urothelial cancer undergoing bladder-sparing surgery during Jan.2013 and Dec.2016 in our hospital were retrospectively analyzed.Tumor recurrence and progression were followed up 2 years after operation.The related factors were analyzed with Cox regression model.ResultsDuring the follow-up of 2 years,recurrence was identified in 55 patients(63.21%),and progression in 24 patients(27.59%).Cox regression analysis showed that tumor size,number of tumors,incipient tumor and bladder instillation regimen were independent factors influencing the recurrence(P<0.05);tumor size,number of tumors and in situ tumor were independent factors influencing the progression(P<0.05).ConclusionIn the treatment of high-grade T1 bladder cancer,factors such as tumor size,number of tumors,in situ tumor,and incipient tumor should be considered.