摘要
目的采用Cox风险回归模型分析膀胱癌预后的影响因素。方法收集2009年5月至2015年1月在河北医科大学附属燕达医院行手术治疗的266例膀胱癌患者的临床资料,采用单因素和多因素Cox回归分析可能影响膀胱癌预后的影响因素。结果Kaplan-Meier法生存分析结果显示,266例患者死亡54例,5年生存率为79.70%(212/266),中位生存时间为69.52个月(95%CI 68.172~70.873)。年龄≥60岁患者中位生存时间短于年龄<60岁患者(64.96个月比70.78个月)(P<0.05),肿瘤直径≥3 cm患者中位生存时间短于肿瘤直径<3 cm患者(66.76个月比69.45个月)(P<0.01),肿瘤多发患者中位生存时间短于肿瘤单发患者(64.99个月比72.25个月)(P<0.01),膀胱部分切除术患者中位生存时间短于膀胱全切术患者(63.94个月比73.28个月)(P<0.01),淋巴结转移患者中位生存时间短于无淋巴结转移者(62.97个月比73.29个月)(P<0.01),肾积水患者中位生存时间短于无肾积水者(56.73个月比73.13个月)(P<0.01),术后辅助放化疗、术后膀胱灌注患者中位生存时间长于术后未开展辅助放化疗和膀胱灌注者(72.53个月比60.41个月、72.65个月比60.14个月)(P<0.01),不同组织分化程度、病理分级、肿瘤分期患者的中位生存时间比较差异有统计学意义(P<0.01)。多因素Cox回归分析结果显示,肿瘤数目、年龄、组织分化程度、手术切除方式、肾积水、病理分级是膀胱癌患者预后的危险因素,术后辅助放化疗是膀胱癌患者预后的保护因素(P<0.05)。结论膀胱癌预后影响因素较多,应在考虑多方面影响因素的基础上制订诊治方案,以改善患者预后。
Objective To use Cox risk regression model to analyze the prognostic factors of bladder cancer.Methods Clinical data of 266 patients with bladder cancer who underwent surgical treatment in Yanda Hospital,Hebei Medical University from May 2009 to Jan.2015 were collected.Univariate Cox regression analysis and multivariate Cox regression analysis were performed to analyze the influencing factors on the prognosis.Results Kaplan-Meier survival analysis showed that 54 of 266 patients died,the 5-year survival rate was 79.70%(212/266),and the median survival time was 69.52 months(95%CI 68.172-70.873).The median survival time of the patients aged≥60 years was shorter than that of the patients aged<60 years(64.96 months vs 70.78 months)(P<0.05).The median survival time of the patients with tumor diameter≥3 cm was shorter than that of the patients with tumor diameter<3 cm(66.76 months vs 69.45 months)(P<0.01).The median survival time of the patients with multiple tumors was shorter than that of the patients with single tumors(64.99 months vs 72.25 months)(P<0.01).The median survival time of the patients with partial cystectomy was shorter than that of the patients with total cystectomy(63.94 months vs 73.28 months)(P<0.01).The median survival time of the patients with lymph node metastasis was shorter than that of the patients without lymph node metastasis(62.97 months vs 73.29 months)(P<0.01),and the median survival time of the patients with hydronephrosis was shorter than that of the patients without hydronephrosis(56.73 months vs 73.13 months)(P<0.01).The median survival time of the patients with postoperative adjuvant chemoradiotherapy and postoperative bladder perfusion was longer than that of the patients without postoperative adjuvant chemoradiotherapy and postoperative bladder perfusion(72.53 months vs 60.41 months,72.65 months vs 60.14 months)(P<0.01).There were significant differences in the median survival time of the patients with different tissue differentiations,pathological grades and tumor stages(P<0.01)
作者
唐伟
杨云波
李晖
张鹏
TANG Wei;YANG Yunbo;LI Hui;ZHANG Peng(Department of Urology,Yanda Hospital,Hebei Medical University,Sanhe 065201,China;Department of Urology,Beijing Chaoyang Hospital,Beijing 100020,China)
出处
《医学综述》
CAS
2022年第21期4333-4337,共5页
Medical Recapitulate
基金
河北省自然科学基金(H2020103010)。
关键词
膀胱癌
生存分析
预后
Bladder cancer
Survival analysis
Prognosis
