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临床结节阳性膀癌患者的预后影响接受激进囊切除术的患者

Pietro Scilipoti¹, Marco Moschini¹, Paolo Zaurito¹

¹Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.

Clinical genitourinary cancer

|June 13, 2025

概括

术前全身疗法 (PST) 与激进囊切除术 (RC) 结合,改善了结节阳性膀癌患者的生存率. 治疗后的病理完整反应 (pCR) 和节点负状态 (pN0) 显著降低了死亡风险.

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.
手术瘤学手术瘤学

背景情况:

临床结节阳性 (cN+) 膀癌 (BCa) 呈现出不同的生物和预后特征.
系统疗法在管理cN+BCa方面越来越重要.
了解激进囊切除术 (RC) 后的瘤结果与外科手术期间的全身疗法至关重要.

研究的目的:

为了检查cN+BCa接受RC的患者的瘤结局.
评估术后全身治疗对生存率和死亡率的影响.
评估治疗后病理反应的预后意义.

主要方法:

一个多中心数据库 (1067名患者) 的回顾性分析,其中cTanyN+M0 BCa接受RC.
纳入标准:cN1-2疾病,在2006-2023年期间进行治疗.
卡普兰-梅尔曲线用于整体存活 (OS),竞争风险累积发病率癌症特异性死亡率 (CSM) 和多变量考克斯回归模型 (MCR) 被使用.

主要成果:

589名患者符合纳入标准,189人接受了手术前全身治疗 (PST),115人接受了RC +辅助治疗 (AT).
三年后的生存率为PST+RC的69%,RC+AT的55%,单独RC的55%. PST+RC与较低的全因死亡率相关 (HR:0.67,P=.042).
病理完整响应 (pCR),部分响应 (pPR) 和pN0状态与较低的全因和癌症特异性死亡风险显著相关.

结论:

接受手术的cN+BCa患者的瘤结果有所不同.
手术前的全身疗法 (PST) 和辅助疗法 (AT) 与改善的整体存活率 (OS) 有关.
病理反应 (pCR,pPR,pN0) 是一个重要的预后指标,支持风险分层和个性化护理.

关键词:

肌肉侵袭性膀癌是一种肌肉侵袭性膀癌.总体生存率总体生存率盆腔淋巴结解剖盆腔淋巴结解剖在外科手术期间进行全身治疗.尿路细胞癌是什么意思

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