在初级与二级肌肉侵入性膀癌中,三模治疗的瘤结果:一个多中心回顾性研究
Garvey Mezepo1, Zine-Eddine Khene2, Jihane Boustani3
1Department of Urology, Andrology, and Kidney Transplantation, University of Franche-Comté, Jean Minjoz University Hospital, Besançon, France.
European urology oncology
|January 23, 2026
概括
用三模治疗 (TMT) 治疗的肌肉侵入性膀癌 (MIBC) 的结果与原发性MIBC (pMIBC) 和二次性MIBC (sMIBC) 类似. 患有非肌肉侵入性膀癌 (NMIBC) 的病史不应阻止患者接受膀保护性TMT.
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.
- 癌症研究 癌症研究
背景情况:
- 肌肉侵入性膀癌 (MIBC) 可以是原发性 (pMIBC) 或二次性 (sMIBC),是由于先前的非肌肉侵入性疾病引起的.
- 二次性MIBC与根性囊切除术后更糟糕的结果有关,但其在三模治疗 (TMT) 后的影响尚不清楚.
研究的目的:
- 为了比较pMIBC和sMIBC之间的结果,在接受膀保护TMT的患者中.
- 评估先前NMIBC史对TMT疗效的预后影响.
主要方法:
- 对294名MIBC患者进行了回顾性分析,这些患者接受了治疗意图的TMT治疗.
- 被归类为pMIBC (诊断时≥T2) 或sMIBC (从NMIBC进展) 的患者.
- 主要终点:无复发的生存率;次要终点:无转移的生存率,癌症特异性生存率 (CSS),整体生存率和毒性. 使用卡普兰-梅尔和考克斯回归分析的生存率.
主要成果:
- 三年CSS率为pMIBC的78%,为sMIBC的79%.
- 在对共变量进行调整后,sMIBC与复发风险增加 (HR 1.35) 或癌症特异性死亡 (HR 0.88) 并无显著关联.
- 3级以上的毒性很少发生;sMIBC患者的整体存活率较低.
结论:
- 保持膀的TMT给pMIBC和sMIBC带来了类似的瘤结果.
- 患有NMIBC病史的患者不应排除在TMT考虑之外.
- 需要进一步的研究和更长的随访,以证实这些发现.
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