评估膀癌对尿道上部癌症的影响 根基性瘤切除术后的预后:以倾向性得分为基础的多中心队列研究
Shicong Lai1,2, Pengjie Wu3, Jianyong Liu4
1Department of Urology, Peking University People's Hospital, Beijing, China.
Annals of surgical oncology
|August 26, 2025
概括
膀癌 (BCa) 的病史会对彻底瘤切除术 (RNU) 后的上道泌尿道癌 (UTUC) 存活率产生负面影响. 加强对这些高风险的UTUC患者的监测至关重要.
科学领域:
- 尿瘤学
- 癌症流行病学
- 外科瘤学
背景情况:
- 膀癌 (BCa) 经常与上部泌尿道癌 (UTUC) 一起发生.
- 之前或随后的BCa诊断对UTUC后果的预后影响尚不清楚.
- 本研究研究了BCa病史与UTUC预后之间的关系.
研究的目的:
- 评估膀癌 (BCa) 病史对接受急性瘤切除术 (RNU) 的患者预后的影响.
- 提供数据,以改善临床决策和患者管理策略,对UTUC患者有BCa史.
主要方法:
- 一项回顾性多中心队列研究,利用来自中国中心的倾向分数匹配 (PSM) 数据和监测,流行病学和最终结果 (SEER) 数据库.
- 患者分为三组:BCa-UTUC (之前的/ 同时的BCa),UTUC-BCa (后来的BCa) 和唯一的UTUC (没有BCa病史).
- 使用卡普兰 - 梅尔分析,日志排名测试和考克斯回归来比较生存结果 (总生存率和癌症特异性生存率) 并确定风险因素.
主要成果:
- 分析包括7249名患者 (1010名来自中国,6239名来自SEER).
- 在中国队列中,BCa-UTUC (HR 2. 334) 和UTUC-BCa (HR 1. 697) 的癌症特异生存率 (CSS) 与仅UTUC相比显著降低.
- 此外,BCa-UTUC也显示总体存活率较低 (HR 2. 404). SEER数据证实了这些发现,将BCa-UTUC和UTUC-BCa与不良的CSS联系起来.
结论:
- 膀癌 (BCa) 史,无论时间 (前期,同时发生或后期),都会对根性瘤切除术 (RNU) 后的上道泌尿道癌 (UTUC) 预后产生不利影响.
- 这些发现强调了对有BCa病史的UTUC患者进行加强监测和量身定制的治疗策略的必要性.
- 识别和管理具有同时存在BCa的高风险UTUC患者对于改善长期结果至关重要.
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