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尿路转移类型与根源性囊切除患者其他原因死亡率之间的关联
Simone Morra1,2, Lukas Scheipner1,3, Andrea Baudo1,4
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada.
Cancers
|January 26, 2024
概括
较复杂的尿路转移,如正位神经膀和腹囊,与激进囊切术后的阴道管相比,不会增加整体并发症率 (OCM) 的风险. 这一发现支持在膀癌治疗中使用各种尿路转移技术.
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.
- 外科手术的结果
背景情况:
- 根源性囊切除术 (RC) 后不同尿路转移 (UD) 技术之间的整体并发症率 (OCM) 的比较风险尚不清楚.
- 具体来说,目前尚不清楚更复杂的UDs,如正管神经膀和腹腔袋,是否与比标准状管更高的OKM率有关.
研究的目的:
- 调查不同类型的尿路转移 (UD) 和激进囊切除术 (RC) 后的整体并发症率 (OCM) 之间的关联.
- 通过使用基于人口的大型数据库,比较 ortotopic 新膀和腹腔袋与乳腺管道的 OCM 率.
主要方法:
- 对在T1-T4aN0M0阶段进行RC的患者的SEER数据库 (2004-2020) 的分析.
- 使用1:1倾向分数匹配 (PSM) 来控制混因素.
- 采用竞争风险回归 (CRR) 模型和累积发病率图表来评估不同类型的UD类型的OCM率的差异.
主要成果:
- 在3008名RC患者中,79%的患者患有乳腺管道,21%的患者患有大陆UD (正位神经膀或腹袋).
- 在PSM之后,无论是大陆UD,正管神经膀,还是腹囊都没有显示出相比以利亚管道显著更高的10年OCM率.
- 经过针对癌症特异性死亡率进行调整的多变量分析证实,更复杂的UD和增加的OCM率之间没有显著的关联.
结论:
- 复杂的尿路转移技术,包括正管神经膀和腹腔袋,与大阴管相比,没有与更高的整体并发症率有关.
- 这些发现表明,对UD的患者选择应该考虑不仅仅是并发症率之外的因素.
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