摘要
目的探索T1期膀胱癌二次电切阳性率的影响因素及二次电切阳性发现对疾病预后的影响。方法收集北京大学第一医院泌尿外科室从2008至2015年因T1期膀胱癌行二次经尿道膀胱肿瘤电切术（re-TURBT）的患者共计72例。分析re-TURBT阳性率的影响因素，并对re-TURBT术后患者进行随访，比较re-TURBT阳性或阴性发现对预后的影响。结果re-TURBT阳性率为33．3％。T1期膀胱癌re-TURBT阳性与肿瘤大小相关（P〈0．05），肿瘤直径较大（／〉4cm）的患者二次电切阳性的可能大，而与肿瘤分级和数目无关。re-TURBT术后随访65例。阳性组3个月内复发率为25％，阴性组3个月内无复发病例，两者差异有统计学意义（P〈0．001）。阳性组和阴性组的肿瘤总复发率、中位无复发生存时间、肿瘤进展率、切除膀胱率、肿瘤特异性死亡率无显著性差异。结论对T1期膀胱癌来说较大体积的肿瘤预示着二次电切的阳性率较高，二次电切结果与肿瘤早期复发相关。
Objective To investigate the predictors of residual tumors at repeat transurethral resection of bladder tumors （re-TURBT） for the patients with T1 bladder cancer and evaluate the effect of the residual tumors on the prognosis of the disease. Methods We reviewed the clinical data of the patients with T1 bladder cancer who underwent re-TURBT from 2008 to 2015 in our department. Seventy-two patients received re-TURBT 2 - 6 weeks after the initial TURBT. A total of 65 patients were followed up, and we recorded the events of tumor recurrence, tumor progression, radical cystectomy and cancer specific death. The influencing factors of re-TURBT positive rate were analyzed. The effects of re-TURBT positive or negative findings on the prognosiswere compared. Results 33.3% of the patients who received re-TURBT had residual tumours. Re-TURBT positive in T1 bladder cancer has significant correlation with tumor size （ P 〈 0. 05 ）. Residual tumors tended to be detected in patients with larger tumors （ diameter ≥ 4 cm） but might have no relationship with tumor grade or tumor number. The recurrence rate within 3 month ofthe patients with residual tumours at re-TURBT was 25% （5/20）, while there were no patients suffering recurrence who had no residual turnouts at re-TURBT, which had a significant difference （ P 〈 0. 001 ）. However, the overall recurrence rate, progression rate, rate of radical cystectomy and cancer specific mortality showed no significant difference between the two groups （ 45% vs 40% , P = 0.71 ; 10% vs 6.7%, P=0.64; 5% vs 8.9%, P=0.59; 5% vs2.2%, P=0.55）. Conclusions For the patients with T1 bladder cancer, larger tumors could be a predictor for residual tumors at re-TURBT. The presence of residual tumors is associated with early recurrence.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第14期1124-1127,共4页
National Medical Journal of China
关键词
膀胱肿瘤
肿瘤残余
Urinary Bladder neoplasms
Neoplasm residual
