膀胱癌根治术治疗高级别T1期膀胱癌的预后分析

Prognostic analysis of high grade T1 bladder cancer treated with radical cystectomy

目的分析膀胱癌根治术治疗高级别T1期(HGT1)膀胱癌的预后影响因素。方法回顾性收集2009年12月至2018年8月于陆军军医大学泌尿外科行膀胱癌根治术的HGT1期患者90例,采用Kaplan-Meier法分析患者术后无复发生存期(RFS)、肿瘤特异性生存期(CSS)及总生存期(OS),并采用Log-Rank法对生存曲线进行统计学差异分析;对RFS、CSS及OS的影响因素采用单因素与多因素Cox回归分析。结果 Kaplan-Meier法结果表明HGT1期患者1年、2年及5年的无复发生存率分别为83.2%、81.8%及70.9%,1年、2年及5年的肿瘤特异性生存率分别为89.2%、79.5%及68.5%,1年、2年及5年的总生存率分别为88.2%、77.4%及66.7%;单因素Cox分析结果表明年龄、淋巴结阳性和术前血红蛋白(HGB)为影响RFS、CSS及OS的因素,肿瘤最大直径≥3cm仅为OS的影响因素;多因素Cox分析结果表明年龄和淋巴结阳性为RFS、CSS及OS的独立危险因素,HGB为RFS、CSS及OS的独立保护因素,肿瘤最大直径≥3cm仅为OS的独立危险因素。结论在行膀胱癌根治术的HGT1期患者中,年龄和淋巴结阳性为RFS、CSS及OS的独立危险因素,HGB为RFS、CSS及OS的独立保护因素,肿瘤最大直径≥3cm仅为OS的独立危险因素。

Objective To analyze the prognostic factors of high grade T1(HGT1)bladder cancer treated with radical cystectomy.Methods The clinicopathological data of 90 patients with HGT1 who received radical cystectomy during Dec.2009 and Aug.2018 were retrospectively analyzed.The recurrence-free survival(RFS),cancer-specific survival(CSS)and overall survival(OS)were analyzed with Kaplan-Meier method,and the statistical difference of survival curves was analyzed with Log-Rank method.The influencing factors of RFS,CSS and OS were analyzed with univariate and multivariate Cox regression analysis.Results The RFS after 1 year,2 years and 5 years were 83.2%,81.8% and 70.9%,respectively.The CSS were 89.2%,79.5% and 68.5%,respectively.The OS were 88.2%,77.4% and 66.7%,respectively.Univariate Coxanalysis showed that age,positive lymph node metastasis and preoperative hemoglobin(HGB)were the influencing factors of RFS,CSS and OS,and maximum tumor diameter≥3 cm was the influencing factor of OS.Multivariate Cox analysis showed that age and positive lymph node metastasis were independent risk factors of RFS,CSS and OS;HGB was the independent protective factor of RFS,CSS and OS;maximum tumor diameter≥3 cm was the independent risk factor of OS.Conclusion Age and positive lymph node metastasis are independent risk factors of RFS,CSS and OS in patients with HGT1 treated with radical cystectomy.HGB is the independent protective factor of RFS,CSS and OS.Maximum tumor diameter≥3 cm is the independent risk factor of OS.