根据EORTC评分行二次膀胱肿瘤电切的回顾性分析

Retrospective analysis of secondary bladder tumor resection based on EORTC score

目的分析经尿道膀胱肿瘤二次电切对非肌层浸润性膀胱癌的临床意义。方法自2009年1月—2015年6月,对某医院179例非肌层浸润性膀胱癌NMIBC接受经尿道膀胱治疗电切治疗的患者进行EORTC评分,分为两组,未接受二次电切121例为对照组,二次电切58例作为观察组,术后后续治疗相同,比较二组膀胱肿瘤术后复发率。结果 58例观察组患者,在首次尿道膀胱肿瘤电切术(TURBT)后4周内均行二次电切,二次电切的患者中,发现肿瘤残余者有7例,7例患者根据EORTC评分,都是中高危组病人。对照组中121例患者在术后有42例患者发现有肿瘤复发,40例为EORTC评分中高危组病人。结论对于行膀胱肿瘤电切的非肌层浸润性膀胱癌患者,进行EORTC评分,不仅可以预测不同临床病理特征膀胱癌患者的复发和进展,二次经尿道膀胱肿瘤电切术能提高患者的生存时间,改善患者的生活质量,有效地遏制膀胱癌的复发和进展。

Objective To explore the clinical significance of the second transurethral resection for non-muscle invasion bladder cancer(NMIBC).Methods From January 2009 to July 2015,179 cases of NMIBC were treated by intracavitary therapy in a hospital.Then European Organization for Research on Treatment of Cancer(EORTC)scores were graded.These cases were divided into a control group of 121 patients without the second transurethral resection of bladder tumor(TURBT),and a trial group of 58 patients who underwent the second TURBT.Both groups received the same subsequent therapy.The rates of recurrence of bladder tumor were compared between two groups.Results A total of 58 patients of the trial group received the second transurethral resection after the first TURBT in four weeks.After the second TURBT,seven of them had residual tumor,and all of them were in high-risk group allotting to EORTC.However,42 cases of the control group were checked out the tumor recurrence after the operation,and 40 cases were in high-risk group allotting to EORTC.Conclusion When EORTC scores were graded to evaluate those patients who received the treatment of second TURBT for NMIBC,we can predict the recurrence and progression of patients with different clinical pathological characteristics of bladder temor,Meanwhile,TURBT can effectively reduce the recurrence of bladder tumor,delay the progress of bladder tumor,and improve the patients’survival time and quality of life.