年龄因素对患者行膀胱癌根治术后疗效的影响及相关因素分析

Influence of age upon prognosis of patients after radical cystectomy and analysis of related factors

目的:探讨年龄因素对根治性全膀胱切除手术患者的影响。方法:收集2011年1月~2019年7月在我院行根治性全膀胱切除手术且临床资料完善的患者52例,分为高龄组(>70岁)和非高龄组,比较两组患者手术时间、术中出血量、术后出院时间等临床数据的差异,同时通过Cox生存分析探讨影响高龄患者全膀胱术后预后的危险因素。结果:两组患者在手术时间、排气时间、胃肠减压时间等方面比较差异无统计学意义(P>0.05),但高龄组住院时间长于非高龄组,差异有统计学意义(P=0.03)。Cox生存分析发现临床分期、病理分级及是否合并淋巴结转移与患者术后预后有关。结论:高龄并不是行根治性全膀胱切除术患者的绝对禁忌,对于基础状态尚可、无淋巴结转移的高龄膀胱癌患者可以选择行根治性手术治疗。

Objective:To investigate the influence of age upon prognosis of patients after radical cystectomy.Method:We retrospectively analyzed the clinical and follow-up data of 52patients with bladder cancer treated by radical cystectomy.The effects of age and other clinical or pathological characteristics on prognosis of the patients were analyzed.Cox proportional hazard regression model was used to analyze the risk factors of the prognosis.Result:After radical cystectomy,the perioperative mortality of the elderly group(>70years)was higher than that of the non-elderly group,but there was no difference in terms of early postoperative complications between two groups.Only in terms of length of hospitalization time,the elderly group was longer than that of the non-elderly group.Multivariate and correlation analyses were performed and showed that there was close correlation between age and tumor stage,grade,size,lymph node metastasis and lymphovascular invasion.Conclusion:The treatment for the elderly patients with bladder cancer by radical cystectomy is safe.Tumor stage,grade and other poor prognosis factors play decisive roles.