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基于西斯的新辅助化疗对膀癌存活率的现实影响:20年研究
Mario de Angelis1,2,3, Francesco Pellegrino4,5, Pietro Scilipoti4,5,6
1Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. deangelis.mario@hsr.it.
World journal of urology
|October 28, 2025
概括
膀癌的新辅助化疗 (NAC) 显著增加,导致更高的病理完整反应率和更好的生存率. 这一趋势表明,NAC有利于接受激进囊切除术的患者.
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.
- 化疗 化疗是一种化学疗法.
背景情况:
- 基于西斯普拉丁的新辅助化疗 (NAC) 是cT2-4aN0M0膀癌 (BCa) 患者的标准.
- 激进囊切除术 (RC) 是这些患者的常见治疗方法.
- 这项研究评估了NAC趋势和生存结果在一个大,现实世界的队列.
研究的目的:
- 分析用于膀癌的NAC管理的时间趋势.
- 评估NAC对病理完整反应 (pT0) 率的影响.
- 评估NAC对癌症特异性死亡率 (CSM) 和总死亡率 (OM) 的影响.
主要方法:
- 对来自23个中心的3138名cT2-4aN0M0BCa患者 (2004-2024) 的回顾性分析.
- 使用估计年百分比变化 (EAPC) 进行时间趋势分析.
- 采用1:1倾向得分匹配 (PSM) 和多变量回归模型 (逻辑和Cox) 进行结果分析.
主要成果:
- 与 pT0 率 (EAPC: +7.6%,p<0.001) 一起,NAC 的使用量显著增加 (EAPC: +9.2%,p<0.001).
- 在PSM后,NAC是pT0 (OR:2.89,p<0.001) 的最强预测因素.
- NAC与5年CSM (HR:0.90,p=0.01) 和OM (HR:0.85,p=0.001) 的减少有关.
结论:
- 在膀癌治疗中,NAC的使用显著增加.
- 增加NAC的使用与较高的pT0率和改善患者存活率相关.
- 追溯性是研究的一个关键局限性.
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