根治性膀胱切除术后的长期疗效及对肾功能的影响。

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urologia Journal Pub Date : 2024-08-01 Epub Date: 2024-05-10 DOI:10.1177/03915603241249231
Yash Manharla Tilala, Sabyasachi Panda, Abhilekh Tripathi, Sachin Sharma, Amiya Shankar Paul, Sanjay Choudhuri, Samir Swain
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引用次数: 0

摘要

导言目的:评估接受根治性膀胱切除术并行盆腔淋巴结切除术的肌浸润性和高风险非肌浸润性膀胱过渡细胞癌患者的临床、肿瘤学结果以及对肾功能的影响,这些患者无非区域淋巴结和远处转移证据:2015年1月至2022年12月期间,共有156名患者接受了根治性膀胱切除术和盆腔淋巴结切除术。共有 132/156 例患者患有原发性膀胱过渡细胞癌。30名患者出现梗阻性肾病,在肾功能稳定后进行了手术。术前和术后采用改良肾病饮食公式计算 eGFR:在本研究中,114 名(86.36%)患者患有高级别 TCC,70 名(53.02%)患者患有器官局限性疾病。74例(56.06%)患者出现结节扩展。围手术期死亡率为 36 例(27.2%)。5年的总生存率和无复发生存率(RFS)分别为66.67%和45.45%。无复发生存率与病理分期、结节状态、组织学分级、手术切缘阳性和手术时间有明显关系。共有 92/132 例(69.7%)患者复发。10/92(10.87%)的患者盆腔复发,82/92(89.13%)的患者远处复发。肾功能稳定后出现梗阻性肾病的患者术前平均肌酐为 2.6 mg/dl,平均 eGFR 为 38.9 ml/h。在中位随访 62 个月期间,46/132(34.8%)例患者术后的 eGFR 有所改善,而 86/132(65.2%)例患者的 eGFR 有所恶化:结论:根治性膀胱切除术的总生存率较高。结论:根治性膀胱切除术具有良好的总体生存效果,术前 eGFR 对术后长期肾功能有显著影响。
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Long term outcomes and impact on renal function following radical cystectomy.

Introduction: To assess clinical, oncological outcomes and impact on renal function in patients who underwent the radical cystectomy with pelvic lymphadenectomy for muscle invasive and high risk non-muscle invasive transitional cell carcinoma of urinary bladder without evidence of non-regional lymph nodes and distant metastasis.

Materials and methods: With curative intent total 156 patients underwent radical cystectomy with pelvic lymphadenectomy from January 2015 to December 2022. Total 132/156 patients had primary transitional cell carcinoma of bladder. Thirty patients, presented with obstructive nephropathy, operated after stabilization of renal function. Pre-operatively and post-operatively eGFR calculated using modified diet in renal disease formula.

Results: In present study 114 (86.36%) patients had high grade TCC, 70 (53.02%) patients had organ confined disease. Nodal extension seen in 74 (56.06%) patients. Perioperative mortality noted in 36 (27.2%) patients. The overall survival and recurrence free survival (RFS) over 5 years was 66.67 and 45.45%. RFS was significantly related to pathological stage, nodal status, histological-grade, positivity of surgical margin and time of surgery from diagnosis. Total 92/132 (69.7%) patients had recurrence. Pelvic recurrence in 10/92 (10.87%) whereas 82/92 (89.13%) patients had distant recurrence. Pre-operatively mean creatinine was 2.6 mg/dl and mean eGFR was 38.9 ml/h in patients who presented with obstructive nephropathy after stabilization of renal function. Post-operatively in 46/132 (34.8%) patients had improvement in eGFR while 86/132 (65.2%) patients had deterioration of eGFR over 62 months of median follow up.

Conclusion: Radical cystectomy provides good overall survival outcomes. Pre-operative eGFR has significant impact on post-operative renal function in long term.

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来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
期刊最新文献
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