膀胱癌根治术后患者前列腺偶发癌临床特征分析

Incidence and clinic characteristics of incidental prostate cancer after radical cystectomy

目的:分析膀胱癌根治术术后前列腺偶发癌的发生率及临床特点。方法:回顾分析我院2014年04月至2020年01月共96例行膀胱癌根治术的患者作为研究对象,其术前均未被诊断为前列腺癌,通过计算前列腺偶发癌的发生率,比较合并前列腺偶发癌和未合并前列腺偶发癌两组患者的年龄、膀胱癌分期之间的差异,以及比较具有临床意义和无临床意义的前列腺癌,两组之间膀胱癌分级分期、肿瘤特异性生存率等指标差异。结果:96例病例中,有14例(14.6%)发现合并前列腺偶发癌,且所有肿瘤分期均在pT_(2)以内。Gleason评分10例≤6分(71.4%),4例≥7分(28.6%)。合并前列腺偶发癌的患者年龄比未合并前列腺偶发癌患者的年龄更大,具有统计学意义。但两组的膀胱癌病理学特征差异无统计学意义。患者总体生存率取决于膀胱癌的分期和淋巴结是否转移,前列腺偶发癌不会降低膀胱癌根治术术后患者的总体存活率。结论:膀胱癌根治术术后无患者死于前列腺癌,可见前列腺偶发癌对膀胱癌患者总体生存率无明显影响,术后无需对前列腺癌进行检测与治疗。

Objective:To analyze the incidence and clinic characteristics of incidental prostate cancer after radical cystectomy.Methods:96 patients with radical bladder cancer surgery from April 2014 to January 2020 in our hospital were analyzed retrospectively.None of them had been diagnosed with prostate cancer before surgery.The differences of age and stage of bladder cancer between patients with incidental prostate cancer and those without incidental prostate cancer were compared,and the differences of clinical significance and non-clinical significance of prostate cancer were compared between the two groups,and the differences of bladder cancer grade and stage and tumor specific survival rate were compared between the two groups.Results:Incidental prostate cancer was found in 14 of 96 patients(14.6%),and all tumors were staged within pT_(2).Gleason score was≤6 in 10 cases(71.4%)and≥7 in 4 cases(28.6%).The age of patients with incidental prostate cancer was older than that of patients without incidental prostate cancer,which was statistically significant.However,there was no significant difference in pathological characteristics of bladder cancer between the two groups.The overall survival rate depended on the stage of bladder cancer and lymph-node metastasis.Incidental prostate cancer did not reduce the overall survival rate of patients after radical cystectomy.Conclusion:No patient died of prostate cancer after radical cystectomy,so the incidental prostate cancer has no significant effect on the overall survival rate of patients with bladder cancer.In order to avoid the waste of medical resource caused by overtreatment,there is meaningless to detect and treat prostate cancer after surgery.