Bing Lan, Rui Luo, Yang Li, Shijie Wang, Wei Jiang, Yun Zhong, Xuneng Zhang, Qingyang Zheng, Zichuan He, Bo Ma, Hui Wang, Keli Yang, Huaiming Wang
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引用次数: 0
Abstract
Background: Limited research exists on colorectal cancer (CRC) patients with bladder invasion, with survival outcomes post-cystectomy underexplored and a debate between partial and total cystectomy ongoing.
Objective: The study aimed to evaluate the effect of pathological bladder invasion on the long-term tumour prognosis of patients with clinically diagnosed bladder invasion in CRC after cystectomy.
Design: Retrospective, cohort study.
Methods: Our study involving 105 CRC patients with bladder invasion who had partial or total cystectomy from 2012 to 2020 collected surgical and pathological data. Groups were divided by pathological bladder invasion presence and compared for 3-year overall survival (OS) and recurrence-free survival (RFS) rates. Multiphoton imaging assessed collagen features in some samples.
Results: Pathological bladder invasion was confirmed in 50 patients (48%). Of 94 who had partial cystectomy, 41 were in the bladder invasion (+) group. The 3-year OS and RFS rates were 62.97% and 57.35% for the bladder invasion (+) group, and 77.16% and 58.68% for the bladder invasion (-) group, with no significant differences in recurrence rates between groups (p > 0.05). There are also no significant differences in 3-year local recurrence and intravesical recurrence rates between the two groups (18.62% vs 25.83%, 7.73% vs 11.82%, p > 0.05). Distant metastasis was identified as an independent risk factor for OS and RFS by univariate and multivariate Cox regression analyses. Of the 24 samples that underwent multi-photon imaging, 142 collagen features extracted did not show statistical differences.
Conclusion: Pathological bladder invasion impacts CRC patients' post-cystectomy survival may be less than what clinical practice implies. Partial cystectomy in cases with pathological bladder invasion might offer similar survival rates to total cystectomy.
背景：对膀胱侵犯的结直肠癌（CRC）患者的研究有限，膀胱切除术后的生存结果尚未得到充分探讨，部分和全部膀胱切除术的争论仍在进行中。目的：探讨病理性膀胱侵犯对临床诊断为结直肠癌膀胱侵犯患者膀胱切除术后远期肿瘤预后的影响。设计：回顾性队列研究。方法：本研究收集了2012年至2020年行部分或全部膀胱切除术的105例结直肠癌膀胱侵犯患者的手术和病理资料。根据病理性膀胱浸润情况进行分组，比较3年总生存率（OS）和无复发生存率（RFS）。多光子成像评估了一些样品中的胶原蛋白特征。结果：病理性膀胱侵犯50例（48%）。在94例膀胱部分切除术患者中，有41例膀胱侵犯（+）组。膀胱浸润（+）组3年OS和RFS分别为62.97%和57.35%，膀胱浸润（-）组3年OS和RFS分别为77.16%和58.68%，两组复发率差异无统计学意义（p < 0.05）。两组3年局部复发率和膀胱内复发率也无显著差异（18.62% vs 25.83%, 7.73% vs 11.82%, p < 0.05）。通过单因素和多因素Cox回归分析，发现远处转移是OS和RFS的独立危险因素。在接受多光子成像的24个样本中，提取的142个胶原特征没有统计学差异。结论：病理性膀胱侵犯对结直肠癌患者膀胱切除术后生存的影响可能小于临床表现。病理性膀胱侵犯的部分膀胱切除术可能提供与全膀胱切除术相似的生存率。试验注册：ChiCTR2300077861。
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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