降低功能对激进囊切除术后癌症不良结果的影响
Dongsu Kim1, Wook Nam2, Yoon Soo Kyung1
1Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Investigative and clinical urology
|July 7, 2023
概括
手术前轻度功能障碍 (GFR 60-90) 在急性囊切除术后对尿路癌患者的生存结果产生负面影响. 较低的GFR预测了较差的无复发性,癌症特异性和整体存活率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
背景情况:
- 激进囊切除术是尿路细胞癌的标准治疗方法.
- 手术前的功能对于手术结果至关重要.
- 轻度功能障碍对瘤结局的影响需要进一步研究.
研究的目的:
- 评估手术前功能障碍对因尿路癌进行激进囊切除术的患者的瘤结局的影响.
- 为了比较正常或轻微功能受损的患者之间的结果.
主要方法:
- 对1096名经过激进囊切除 (2004-2017年) 的尿癌患者进行了回顾性审查.
- 根据手术前的膜过率 (GFR) 将患者分为两组:GFR≥90毫升/分钟/1.73平方米 (n=89) 和60≤GFR<90毫升/分钟/1.73平方米 (n=246).
- 分析了包括复发,癌症特异性存活率和整体存活率在内的瘤结果.
主要成果:
- 患有60-90毫升/分钟/1.73米2的GFR患者的无复发存活时间显著较短 (85.7个月与125.5个月,p=0.030).
- 在GFR60-90组中观察到癌症特异性存活率较低的趋势 (95.5 vs 131.7个月,p=0.051).
- 在GFR为60-90毫升/分钟/1.73米2 (79.5 vs 123.3个月,p=0.004) 的患者中,整体存活率显著降低.
结论:
- 术前膜过率在60-90毫升/分钟/1.73平方米之间是不良瘤结果的独立预后因素.
- 轻度功能障碍与急性囊切除术后的无复发性,癌症特异性和整体存活率较差有关.
- 这些发现凸显了手术前功能评估在预测尿癌患者的存活率方面的重要性.
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