摘要
目的 探讨膀胱部分切除术（PC）在局限性肌层浸润性膀胱癌（MIBC）治疗中的价值.方法 回顾性分析1999年9月至2005年4月收治的71例局限性MIBC患者的临床资料,男59例,女12例.年龄27～83岁,平均66岁.肿瘤≤3 cm 34例,肿瘤＞3 cm 37例.有脉管瘤栓10例.单发肿瘤42例,多发肿瘤29例.71例均为T2～T3期.肿瘤有蒂18例,广基29例.病理诊断为腺癌6例,肉瘤样癌3例,小细胞癌1例.低分级11例,高分级50例.47例行PC,24例行膀胱全切术（TC）.采用Kaplan-Meier法比较两种术式对患者5年总生存率（OS）和无病生存率（DFS）的影响.单因素与多因素分析临床病理特征与生存率的相关性. 结果 PC组OS与DFS分别为57％（27例）与53％（25例）,TC组OS与DFS分别为50％（12例）与46％（11例）,两组比较差异无统计学意义（P＞0.05）.单因素分析结果显示影响MIBC预后的因素为肿瘤是否有蒂及肿瘤浸润深度（包括是否有脉管瘤栓）,而患者年龄、性别、肿瘤数量、大小及组织学类型与预后无相关性.多因素分析显示,肿瘤浸润深度是影响MIBC预后的独立危险因素,相对危险度=1.64（P＜0.05）. 结论PC不会降低有选择的局限性MIPC患者的肿瘤控制率.
Objective To evaluate the efficacy of partial cystectomy in treatment of localized muscle invasive bladder cancer. Methods From 1999 to 2005,data from 71 patients with muscle in- vasive bladder cancer（MIBC） were reviewed. There were 47 patients underwent partial cystectomy （PC） and 24 underwent total cystectomy （TC）. The overall survival and disease-free survival in pa- tients with MIBC with PC or TC were compared. All patients had pathologic T2- T3. Matched Kap- lan-Meier survival analyses compared the effect of PC vs. TC on overall survival and dlsease-free sur- vival. Univariate （log rank） and multivariate （Cox＇ proportional hazard model） analyses were used to test the statistical significance of several potential prognostic factors for survival rate. Results In the entire cohort,the overall survival rate and disease--free survival rate estimated at 5 years were 57 and 50% for PC patients, 53% and 46% for TC patients, respectively （P〉0.05）. On univariate anal- ysis, T stage （include vessel tumor embolus） and whether the tumor was pedunculated were the sig- nificant predictors of tumor recurrence. Age, gender, tumor quantity, tumor size and histology cate- gory were not associated with prognosis. Cox proportional hazard regression model confirmed that the independent prognosis factors of tumor was T stage （EXP（B） = 1.64, P 〈0.05）. Conclusions PC might not undermine cancer control in appropriately selected patients with MIBC.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2013年第7期497-500,共4页
Chinese Journal of Urology
关键词
浸润性膀胱癌
膀胱切除术
生存率
Muscle invasive bladder cancer Cystectomy
Survival
