在中等风险的非肌肉侵入性膀癌中进行辅助性静脉内疗法
Ekaterina Laukhtina1, Paolo Gontero2, Marko Babjuk1,3
1Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
BJU international
|April 16, 2024
概括
辅助性静脉治疗改善了中等风险的非肌肉侵入性膀癌 (NMIBC) 的无复发生存期 (RFS). 然而,在没有特定风险因素的患者中没有观察到这种益处.
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.
- 癌症研究 癌症研究
背景情况:
- 中级风险的非肌肉侵入性膀癌 (NMIBC) 在治疗决策方面存在挑战,原因是诊断标准重叠.
- 辅助疗法旨在改善NMIBC患者的瘤结果.
- 辅助治疗对中等风险NMIBC的确切影响需要进一步澄清.
研究的目的:
- 评估辅助疗法的有效性,以改善中等风险NMIBC患者的瘤结局.
- 评估辅助疗法与无复发存活率 (RFS) 和无进展存活率 (PFS) 之间的关联.
主要方法:
- 对2206名中等风险NMIBC患者的回顾性分析,这些患者接受过尿道切除膀瘤 (TURBT) 治疗.
- 排除低风险或高风险NMIBC患者.
- 考克斯回归模型被用来评估辅助疗法 (卡尔梅特 - 格林菌,米托米辛C,epirubicin) 对RFS和PFS的影响.
主要成果:
- 辅助疗法与显著改善的RFS (HR 0.79,P < 0.001) 相关,但与PFS (P = 0.09) 不相关.
- 在具有风险因素 (年龄>70,多重,复发,大小≥3cm) 的患者中,辅助疗法改善了RFS (HR 0.78,P < 0.001).
- 在没有风险因素的患者中 (年龄≤70,初级,单一,2级,<3厘米的瘤),辅助疗法与RFS没有显著的关联 (HR 0.71,P = 0.06).
结论:
- 在中等风险NMIBC患者中,辅助静脉内治疗在RFS方面提供了好处.
- 辅助疗法减少复发的好处主要在具有已确定的风险因素的患者中观察到.
- 对于没有特定风险因素的中等风险NMIBC患者,辅助静脉内治疗可能不会显著降低复发率.
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