肾盂癌与输尿管癌术后预后分析

Prognostic analysis of pelvis and ureteral carcinoma

目的探讨肿瘤位置(肾盂和输尿管)对上尿路尿路上皮癌(UTUC)病人总体生存期(OS)和无进展生存期(PFS)的影响。方法回顾性分析2014年1月至2019年8月兰州大学第二医院收治的167例UTUC病人的临床资料。采用Kaplan-Meier法绘制生存曲线,并用Log-rank检验生存曲线的差异。采用单因素和多因素Cox风险比例模型分析影响UTUC病人预后的危险因素。结果所有病人中位随访时间为42(3~89)个月。相对于输尿管肿瘤,肾盂肿瘤更大。Kaplan-Meier并Log-rank检验结果显示,肿瘤位置与病人OS及PFS无统计学差异。Cox多因素回归分析显示,肿瘤G分级、病理T分期和术前纤维蛋白原(FIB)升高是OS的独立危险因素,病理T分期和术前FIB升高是PFS的独立危险因素。结论肿瘤位置与UTUC病人预后无关,在治疗和术后预防的临床决策方面不应该有差异。

Objective To assess the effect of tumor location(pelvis VS ureter)on overall survival(OS)and progression-free survival(PFS)in patients with upper urinary tract urothelial carcinoma(UTUC).Methods The clinical data of 167 UTUC patients admitted to the Second Hospital of Lanzhou University from January 2014 to August 2019 were retrospectively analyzed.Kaplan-Meier analysis was used to assess the OS and PFS and test the equivalences of the curve by Log-rank test.Univariate and multivariate survival analyses was carried out using Cox proportional hazard regression model.Results Median follow-up time was 42(3-89)months.In general,the renal pelvis tumors were larger than the ureteral tumors.The survival curve showed that there was no significant difference between tumor location and Prognosis.Multivariate analysis with a Cox proportional hazards regression model was performed and showed that tumor grading,pathological T stage and FIB was significantly correlated with OS,pathological T stage and FIB were significantly correlated with PFS.Conclusions Tumor location is independent of prognosis in patients with UTUC,and there should be no difference in clinical decisions regarding therapy or postoperative prevention.