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手术后并发症对膀癌患者的长期生存的影响
Takashige Abe1, Shuhei Yamada1, Hiroshi Kikuchi1,2
1Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Japanese journal of clinical oncology
|July 18, 2023
概括
激进囊切除术后的术后并发症对膀癌患者的长期生存有显著影响. 较高的综合并发症指数得分与较差的整体和无复发生存结果相关.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 在瘤学瘤学.
背景情况:
- 激进囊切除术是肌肉侵入性膀癌的标准治疗方法.
- 手术后的并发症会影响患者的结果和生活质量.
- 量化并发症对长期生存的影响对于患者管理至关重要.
研究的目的:
- 为了评估术后并发症和膀癌患者进行激进囊切除术的长期存活之间的关联.
- 确定综合并发症指数 (CCI) 是否是整体存活率和无复发存活率的预测指标.
主要方法:
- 对766名膀癌患者进行了彻底囊切除术的回顾性多机构研究.
- 90天内出现的并发症使用克拉维恩-丁多系统进行分级,并使用综合性并发症指数 (CCI) 进行汇总.
- 生存结果按CCI分层 (高:≥26.2;低:<26.2) 并使用多变量模型进行分析.
主要成果:
- 70%的患者出现任何并发症,24%出现严重并发症 (≥Clavien-Dindo III级).
- 患有CCI≥26.2 (34%) 的患者的整体存活时间 (4年:59.5% vs. 69.8%) 和无复发存活时间 (51.9% vs. 60.1%) 显着较短.
- 较高的CCI,年龄,表现不佳状态,pT阶段和pN阶段是不良生存结果的独立预测因素.
结论:
- 术后并发症,通过综合并发症指数量化,对膀癌患者的长期生存有不利影响.
- 医生必须认识到,严重的术后并发症可能会对激进囊切除术后的长期疾病控制产生负面影响.
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