激进囊切除术后尿路转移的时间趋势和临床决定因素
Francesco Pellegrino1,2, Mario de Angelis2,3,4, Pietro Scilipoti2,3,5
1Department of Urology, ASST Santi Paolo E Carlo, University of Milan, Milan, Italy.
BJU international
|October 6, 2025
概括
根源性囊切除术后的尿路转移趋势显示,皮肤尿路静脉切除术 (UCS) 的使用增加,新膀重建减少. 这种转变与老龄化,更生病的患者群体进行激进囊切除相吻合.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 医学趋势 医学趋势
背景情况:
- 激进囊切除术 (RC) 是肌肉侵入性膀癌的主要治疗方法.
- 尿路转移 (UD) 是RC之后的必要程序.
- 选择UD影响患者的治疗结果和生活质量.
研究的目的:
- 分析激进囊切除术 (RC) 后尿路转移 (UD) 技术的时间趋势.
- 为了在20年内确定与不同类型的UD相关的患者特征.
- 了解不断变化的患者个人资料对UD选择的影响.
主要方法:
- 分析了2004年至2024年间在23个国际中心接受RC治疗的6469名患者.
- 使用估计年度百分比变化 (EAPC) 评估皮肤尿路静脉切除 (UCS),大阴管 (IC) 和新膀的趋势.
- 多变量分析 (MVA) 以确定UD类型的预测因素和患者特征的时间变化.
主要成果:
- 阴道 (IC) 仍然是最常见的UD (56%),没有显著变化.
- 皮肤尿管静止术 (UCS) 的使用显著增加 (总体上14%,从2%到22%,EAPC9.9%).
- 新膀的使用率下降 (总体下降31%,从41%降至19%,EAPC下降2%),与老年,并发症和晚期疾病有关.
结论:
- 在过去二十年中,UD偏好发生了显著的变化,优于UCS而不是 neobladder.
- 接受RC的老年并发症患者比例的增加影响了UD的选择.
- 由于患者人口统计和外科实践的不断变化,需要量身定制的UD策略和优化的外科期间管理.
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