膀胱癌根治术后患者的生存分析

Survival analysis of patients with bladder cancer after radical resection

目的探讨对膀胱癌根治术后患者生存产生影响的相关因素。方法选取2010年2月—2021年8月新疆医科大学第一附属医院收治的148例膀胱癌根治术患者。其中女性患者18例,平均年龄65岁,男性患者130例,平均年龄63岁。分期Tis 1例,Ta 4例,T134例,T2a 25例,T2b 42例,T332例,T410例。淋巴结转移23例,无淋巴结转移125例。截止随访时间2022年5月存活78例,死亡70例。采用电话随访和门诊检查随访对所有患者进行调查,回顾式随访查看患者的一般情况,临床基本信息和术后生存情况,多因素Cox分析影响生存的因素。结果年龄≥70岁的患者比<70岁的患者死亡相对风险度增加0.952倍;病理高级别患者比病理低级别患者死亡相对风险度增加1.378倍;T3期及以上分期患者相较Tis、T1、T2期患者死亡相对风险度增加0.929倍,淋巴结转移或远处转移患者比Tis、T1、T2期患者死亡相对风险度增加3.575倍;腹腔镜手术患者比开腹手术患者死亡相对风险度增加1.265倍。结论更小的年龄、更低的病理级别、更早的分期和合理的手术方式可以带给患者更好的生存情况。年龄、病理级别、病理分期、手术方式是影响患者预后生存情况的因素。

Objective To investigate the related factors affecting the survival of patients with bladder cancer after radical resection.Methods From February 2010 to August 2021,148 patients with bladder cancer underwent radical resection in The First Affiliated Hospital of Xinjiang Medical University.Among them,there were 18 female patients with an average age of 65 years and 130 male patients with an average age of 63 years.Tis 1 cases,Ta 4 cases,T134 cases,T2a 25 cases,T2b 42 cases,T332 cases,T410 cases.23 cases had lymph node metastasis and 125 cases had no lymph node metastasis.Up to may 2022,78 cases survived and 70 died.Results The relative risk of death in patients aged 70 or older was 0.952 times higher than that in patients aged less than 70.The relative risk of death in patients with high-grade pathology was 1.378 times higher than that in patients with low-grade pathology.The relative risk of death in patients with stage T3 and above was 0.929 times higher than that in patients with stage tis,T1 and T2,and the relative risk of death in patients with lymph node metastasis or distant metastasis was 3.575 times higher than that in patients with stage tis,T1 and T2.The relative risk of death in patients undergoing laparoscopic surgery was 1.265 times higher than that in patients undergoing open surgery.Conclusion Younger age,lower pathological grade,earlier stage and reasonable operation method can bring better survival to patients.Age,pathological grade,pathological stage and operation mode are the factors affecting the prognosis and survival of patients.