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对非肌肉侵入性膀癌的监测:确定收益减少的点

Daniel Ranti¹, Linda Dey², Christine Bieber¹

¹Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY.

|August 21, 2023

概括

这项研究分析了26年来膀癌复发模式. 在5年内没有复发的患者可能受益于不那么密集的监测,无论最初的风险类别如何.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.
流行病学流行病学

背景情况:

非肌肉侵入性膀癌 (NMIBC) 需要长期监测复发情况.
了解复发模式对于优化后续策略至关重要.

研究的目的:

在NMIBC患者中描述第一次和第二次复发模式.
评估基于无复发间隔调整监测强度的可能性.

主要方法:

在斯德哥尔摩县1995-1996年间诊断出386名NMIBC患者的队列被跟踪了26年.
使用微模拟建模,使用后勤回归,卡普兰梅尔曲线和考克斯模型来预测复发和进展.
数据包括临床和病理信息,模拟了1万名患者的结果.

主要成果:

第一次复发的中位时间为300天.
在15年内,第一次复发率为56.6% (低风险),62.8% (中等风险) 和48.7% (高风险),相关的肌肉侵入性进展率分别为2.2%,4.3%和14.3%.
首次复发后的第二次复发率为70.7% (低风险),75.7% (中等风险) 和84.7% (高风险). 第一次复发在9年后很少发生.

结论:

在5年内没有复发的NMIBC患者可能是不那么密集的监测候选人.
这种方法有可能减少医疗保健负担,而不会影响患者的治疗结果.

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