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在现实世界中,激进囊切除是否比膀保守治疗有更好的预后?

Ryunosuke Nakagawa¹, Kouji Izumi¹, Ren Toriumi¹

¹Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

International journal of urology : official journal of the Japanese Urological Association

|February 15, 2024

概括

激进囊切除术为肌肉侵入性膀癌提供了比保守治疗更好的生存率. 然而,保守的方法导致更高的再住院和更长的住院时间,这可能会影响生活质量.

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.
公共卫生公共卫生

背景情况:

肌肉侵入性膀癌 (MIBC) 需要治疗决策平衡生存和生活质量.
激进囊切除术 (RC) 和膀保守治疗 (BCT) 是MIBC的主要治疗选择.
现实世界的数据对于比较这些治疗方式的长期结果至关重要.

研究的目的:

为了在现实环境中对MIBC进行RC和BCT之间的预后和生活质量的比较.
评估整体存活率,无进展存活率和再住院率.
评估治疗选择对患者结果和医疗资源利用的影响.

主要方法:

对141名被诊断为非转移性MIBC的患者进行了回顾性分析.
进行RC (n=79) 和BCT (n=62) 的患者之间的结局比较.
评估整体存活率,无病变存活率,再住院率和住院时间.

主要成果:

与BCT相比,RC与明显更好的无进展生存率 (HR: 1.83) 和整体生存率 (HR: 1.82) 相关.
拒绝RC并接受BCT的患者与接受RC的患者之间没有观察到预后的显著差异.
与RC相比,BCT导致重新住院率 (69.3%与34.2%) 和住院时间更长 (26与9天) 显著增加.

结论:

与MIBC的RC相比,BCT与预后较差和医疗利用率增加有关.
虽然RC证明了生存益处,但决策过程应考虑个体患者的因素和生活质量.
较高的住院率和长时间的BCT住院可能会对MIBC患者的生活质量产生负面影响.

关键词:

进行保守的治疗.住院治疗住院治疗肌肉侵入性膀癌膀癌是一种肌肉侵入性膀癌.人们的生活质量.进行激进的囊切除术.

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