在肌肉侵入性膀癌的部分囊切术之前最大尿道切除的作用
Won Sik Ham1, Jee Soo Park1, Won Sik Jang1
1Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Annals of surgical oncology
|October 26, 2023
概括
最大透尿切除 (TUR) 在肌肉侵入性膀癌 (MIBC) 中显著改善了部分囊切除 (PC) 的瘤结局. 这种方法提高了无复发和癌症特异性存活率,为不适合激进治疗的患者提供了可行的选择.
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.
- 手术瘤学手术瘤学
背景情况:
- 肌肉侵入性膀癌 (MIBC) 通常需要激进囊切除术 (RC) 或三节治疗 (TMT).
- 部分囊切除术 (PC) 是选择MIBC患者的替代方案.
- 对于MIBC,最大透尿切除 (TUR) 与PC结合的作用尚不清楚.
研究的目的:
- 评估最大TUR对接受MIBCPC的患者癌症结局的影响.
- 为了比较最大 TUR 的患者和没有最大 TUR 的患者之间的生存率.
- 确定最大的TUR是否是PC对MIBC成功的一个重要因素.
主要方法:
- 在2006年至2018年期间接受PC的98名MIBC患者的回顾性分析.
- 根据他们是否经历了最大的TUR (71名患者) 或没有 (27名患者) 进行患者分类.
- 卡普兰-梅尔分析无复发存活率 (PFS),骨盆无复发存活率 (pPFS),癌症特异性存活率 (CSS) 和整体存活率 (OS);可变分析的考克斯回归.
主要成果:
- 接受最大TUR治疗的患者显示5年后PFS (42.5%对20.3%),PPFS (50.7%对24.1%) 和CSS (74.0%对51.0%) 的显著增加.
- 多变量分析证实最大TURR是改善PFS (HR=0.500),ppFS (HR=0.353) 和CSS (HR=0.416) 的重要预测因素.
- 最大TUR没有显著影响整体存活率 (OS) (HR=0.618).
结论:
- 部分囊切除术 (PC) 为MIBC患者提供了可接受的瘤结果.
- 最大透尿切除 (TUR) 是提高MIBCPC的瘤学结果的关键因素.
- 在最大 TUR 之后的 PC 是不能接受 RC 或 TMT 的 MIBC 患者推的治疗选择.
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