术后化疗和激进囊切除术在治疗膀癌的有效性
Roger Li1, Shreyas Naidu1, Wenyi Fan2
1Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL; Department of Immunology, H. Lee Moffitt Cancer Center, Tampa, FL.
Urologic oncology
|October 25, 2023
概括
术后化疗在肌肉侵入性膀癌 (MIBC) 中提供了适度的益处,而手术前化疗只能帮助cT2患者. 辅助化疗显著改善了晚期MIBC病例的生存率.
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.
- 临床试验 临床试验
背景情况:
- 对肌肉侵入性膀癌 (MIBC) 的术后化疗实践数据有限.
- 治疗前阶段和并发症对MIBC化疗有效性的影响尚不清楚.
研究的目的:
- 评估 MIBC 患者经过激进囊切除术的术后化疗在现实世界中的使用情况.
- 评估化疗对病态衰退和无复发生存期的影响.
主要方法:
- 对1700多名MIBC患者进行彻底囊切除术的回顾性审查.
- 使用卡普兰-梅尔和考克斯比例危险模型分析无复发生存率和整体生存率.
主要成果:
- 术前化疗增加了cT2+MIBC下降阶段的比率,但只有利于cT2患者无复发和整体存活.
- 在具有不良病理特征 (≥pT3或pN+) 的患者中,辅助化疗改善了无复发和整体存活率.
结论:
- 现实世界结果显示,手术前化疗的益处很小,主要是在cT2 MIBC中.
- 辅助化疗对病理发达的MIBC患者有益,无论pT/N阶段.
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