膀袖口切除在激进的nephroureterectomy改善了在上道泌尿器官癌症的生存率
Francesco Di Bello1, Carolin Siech2, Mario de Angelis3
1Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
Urologic oncology
|March 21, 2025
概括
用膀切除 (BCE) 进行激进脏切除术 (RNU),显著降低上道泌尿道癌 (UTUC) 患者的癌症特异性死亡率. 这项研究强调了BCE作为RNU不可或缺的一部分的重要性,以改善生存结果.
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:
- 上道泌尿道癌 (UTUC) 是一种罕见的恶性瘤.
- 激进性瘤切除术 (RNU) 是局部性UTUC的标准手术治疗方法.
- 膀袖口切除 (BCE) 是RNU的关键组成部分,旨在切除整个瘤并防止复发.
研究的目的:
- 根据BCE的纳入或排除,根据RNU后对pT1-T3N0 UTUC患者的生存差异进行评估.
- 确定 BCE 对癌症特异性死亡率 (CSM) 和其他原因死亡率 (OCM) 的影响.
主要方法:
- 对监测,流行病学和最终结果 (SEER) 数据库 (2004-2020) 的分析.
- 对接受RNU的患者的识别和ECB状态的文档.
- 倾向性得分匹配 (1:1比率),其次是累积发病率图和竞争风险回归模型 (CRR) 来评估CSM和OCM.
主要成果:
- 总共分析了4426名RNU患者;72%接受了BCE.
- 从2004年到2020年,欧洲央行利率大幅上升.
- 在倾向分数匹配后,5年CSM率在ECB组为30%,而非ECB组为36%.
- 与 BCE 的 RNU 独立地与较低的 CSM 相关 (HR: 0.81, P < 0.001),但没有影响 OCM.
结论:
- 随着时间的推移,在RNU期间采用指导方针推的 BCE 增加了.
- 结合BCE的RNU与pT1-T3N0UTUC患者的癌症特异性死亡率显著降低有关.
- 应将BCE视为全面RNU的重要组成部分,以获得最佳的患者结果.
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