根治性膀胱切除术前膀胱肿瘤经尿道完全切除不是器官限制性膀胱癌的危险因素:一项病例对照研究。

IF 0.9 4区 医学 Q4 UROLOGY & NEPHROLOGY Current Urology Pub Date : 2022-09-01 Epub Date: 2022-08-27 DOI:10.1097/CU9.0000000000000110
Xiaoxu Yuan, Mingkun Chen, Jing Yang, Yunlin Ye
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引用次数: 0

摘要

目的:探讨膀胱根治术(RC)前经尿道膀胱肿瘤全切除术(turt)在器官限制性膀胱癌治疗中的作用。材料与方法:回顾性分析2008年1月至2018年12月在我中心接受RC治疗的患者资料。排除T2N0M0以上病变、手术切缘阳性及接受新辅助/辅助化疗或放疗的患者。完全性TURBT定义为TURBT术后内镜检查无可见病变或膀胱标本RC术后无可见病变。Kaplan-Meier曲线和log-rank检验评估无病生存期(DFS)。进行Logistic和Cox回归分析以确定潜在的预测因素。结果:本综述共纳入236例患者,其中男性207例,中位年龄61岁。肿瘤中位大小为3cm,共有94例患者确诊为病理T2期疾病。完全TURBT与肿瘤大小(p = 0.041)、组织学变异(p = 0.026)和分期下降(p < 0.001)相关。肿瘤大小、分级和组织学变异是完全TURBT的独立预测因素。在中位42.7个月的随访期间,30例患者出现疾病复发。年龄和组织学变异是DFS的独立预测因子(p分别为0.022和0.032),而完全TURBT不是DFS的独立预测因子(p = 0.156)。降低分期与生存结果无关。结论:完全TURBT与RC前降期率增加相关。它与器官局限性膀胱癌患者更好的肿瘤预后无关。
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Complete transurethral resection of bladder tumor before radical cystectomy is not a risk factor for organ-confined bladder cancer: A case-control study.

Objectives: To investigate the role of complete transurethral resection of bladder tumor (TURBT) before radical cystectomy (RC) for organ-confined bladder cancer.

Materials and methods: Data of patients who underwent RC in our center from January 2008 to December 2018 were retrospectively reviewed. Patients with >T2N0M0 disease and positive surgical margins and those who received neoadjuvant/adjuvant chemotherapy or radiotherapy were excluded. Complete TURBT was defined as no visible lesion under endoscopic examination after TURBT or in the bladder specimen after RC. Kaplan-Meier curves and log-rank tests assessed disease-free survival (DFS). Logistic and Cox regression analyses were performed to identify potential predictors.

Results: A total of 236 patients were included in this review, including 207 males, with a median age of 61 years. The median tumor size was 3 cm, and a total of 94 patients had identified pathological T2 stage disease. Complete TURBT was correlated with tumor size (p = 0.041), histological variants (p = 0.026), and down-staging (p < 0.001). Tumor size, grade, and histological variants were independent predictors of complete TURBT. During a median follow-up of 42.7 months, 30 patients developed disease recurrence. Age and histological variants were independent predictors of DFS (p = 0.022 and 0.032, respectively), whereas complete TURBT was not an independent predictor of DFS (p = 0.156). Down-staging was not associated with survival outcome.

Conclusions: Complete TURBT was correlated with an increased rate of down-staging before RC. It was not associated with better oncologic outcomes for patients with organ-confined bladder cancer.

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Current Urology
Current Urology Medicine-Urology
CiteScore
2.30
自引率
0.00%
发文量
96
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