对于固体器官移植接受者的膀癌的激进囊切除术
Elena Tonin1,2, Lorenzo Bianchi1, Angelo Mottaran1
1Division of Urology, IRCCS University Hospital, Bologna, Italy.
Minerva urology and nephrology
|April 29, 2025
概括
由于膀癌而接受激进囊切除术的固体器官移植接受者 (SOTR) 的整体存活率和癌症特异性存活率明显较差. 这些发现强调了需要对患有膀癌的SOTR进行仔细的患者咨询和随访.
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.
- 移植手术 移植手术
背景情况:
- 固体器官移植接受者 (SOTRs) 由于免疫抑制疗法增加了癌症风险.
- 激进囊切除术 (RC) 和盆腔淋巴结解剖 (PLND) 是膀癌 (UBC) 的标准治疗方法.
- 之前的固体器官移植对UBCRC后的生存结果的影响尚未得到充分证实.
研究的目的:
- 用RC和PLND治疗UBC的SOTR和非SOTR之间比较生存结果 (总生存率和癌症特异性生存率).
- 在这个患者群体中确定生存的预测因素.
主要方法:
- 对645名接受UBCRC和PLND治疗的患者 (2002-2022) 的回顾性分析.
- 患者被分为SOTRs和非SOTRs组.
- 混合效应的考克斯回归分析用于评估总生存期 (OS) 和癌症特异性生存期 (CSS) 的共同初级终点.
主要成果:
- 与非SOTR相比,SOTRs (n=23) 的12个月和24个月的OS和CSS率显著较低 (分别为P=0.011和P=0.016).
- 之前的固体器官移植 (OR: 5.2 OS,OR: 3.0 CSS) 和更高的病理阶段是较差生存的独立预测因素.
- 接受任何系统性治疗与改善的生存率有关 (OR:0.3对于OS,OR:0.4对于CSS).
结论:
- 与非SOTR相比,接受UBCRC和PLND的SOTRs的生存结果较差.
- 这些发现强调了量身定制的患者咨询,警的后续策略的重要性,并在未来的临床试验设计中考虑与UBC的SOTRs.
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