上尿路上皮癌患者肾切除术后理想的膀胱镜检查间隔时间。

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY World Journal of Urology Pub Date : 2024-11-06 DOI:10.1007/s00345-024-05302-9
Shuto Konta, Kohei Hashimoto, Tetsuya Shindo, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori
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引用次数: 0

摘要

目的:本研究的目的是通过一个假设模型,明确上尿路上皮癌(UTUC)肾切除术(NU)后膀胱镜检查的适当间隔时间:方法: 对 15 年来接受肾切除术的 155 名患者进行了回顾性评估。建立了三种监测间隔假设模型:3个月(模型1)、6个月(模型2)和12个月(模型3)。我们将这些模型叠加到每位患者的实际监测中,并分析了观察到的复发时间。从复发到预定膀胱镜检查的时间(timeRCS)被定义为从复发到估计膀胱镜检查的时间。根据模型1中术后0-1年的平均时间RCS计算间隙风险比:中位随访时间为 20.5 个月。63例患者(40.6%)观察到膀胱内复发。NU 前无膀胱癌病史患者的 3 年无膀胱内复发生存率明显高于有膀胱癌病史的患者(61% 对 42%,P = 0.034)。模型1、2和3的时间RCS中值分别为1.9、2.9和8.4个月。对于有膀胱癌病史的患者,模型 1 在 1-3 年时、模型 2 在 2-3 年时、模型 2 在 1-3 年时对于无膀胱癌病史的患者的差距风险比均小于 1.0:模型分析表明,膀胱镜随访时间间隔可根据有无膀胱癌病史以及NU后的时间而延长。
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Ideal cystoscopic interval after nephroureterectomy in patients with upper tract urothelial carcinoma.

Purpose: The purpose of this study was to clarify the appropriate cystoscopic interval after nephroureterectomy (NU) for upper tract urothelial carcinoma (UTUC) using a hypothetical model.

Methods: A total of 155 patients who underwent NU in 15 years were retrospectively evaluated. Three hypothetical models for surveillance intervals were created: 3 (model 1), 6 (model 2) and 12 months (model 3). We superimposed these models on the actual surveillance of each patient and analyzed the observed timing of recurrence. The time from recurrence to scheduled cystoscopy (timeRCS) was defined as the time from recurrence to estimated cystoscopy. The gap risk ratio was calculated based on the average of timeRCS for model 1 at 0-1 year after surgery.

Results: The median follow-up was 20.5 months. Intravesical recurrence was observed in 63 patients (40.6%). The 3-year intravesical recurrence-free survival rate in patients without a history of bladder cancer before NU was significantly higher than in those with a history of bladder cancer (61% vs. 42%, P = 0.034). The medians of timeRCS for models 1, 2, and 3 were 1.9, 2.9, and 8.4 months, respectively. The gap risk ratios for model 1 at 1-3 years, model 2 at 2-3 years for patients with a history of bladder cancer, and model 2 at 1-3 years for patients without a history of bladder cancer were less than 1.0.

Conclusion: Model analysis shows that the cystoscopic follow-up interval can be extended depending on the presence or absence of a history of bladder cancer and the time after NU.

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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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