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治疗性手术后对侧重复发的上道泌尿瘤:一个多中心的回顾性队列研究

Yao-Lin Kao¹, I-Hsuan Alan Chen², Chia-Cheng Yu²

¹Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Therapeutic advances in urology

|February 16, 2026

概括

在初始治疗后,逆侧上道泌尿道癌 (UTUC) 复发可以通过第二次脏切除术 (NUR) 或脏节约手术 (NSS) 进行管理. 这两种方法都显示了与初级NUR相比的生存结果,表明UTUC复发管理的有效性相似.

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.
外科手术的结果

背景情况:

上道泌尿道癌 (UTUC) 的逆侧重复发是一个重大的临床挑战.
关于复发性UTUC的最佳外科治疗策略的证据有限.

研究的目的:

为了比较对手UTUC复发的瘤结果.
评估第二次脏切除术 (NUR) 和脏节约手术 (NSS) 管理的患者的结果.
将结果与接受初级NUR的患者进行比较.

主要方法:

一项多中心回顾性队列研究分析了来自台湾UTUC注册表 (2018-2024) 的3159名UTUC患者.
患者被分为:单边UTUC的初级NUR,对抗性复发的第二个NUR和对抗性复发的NSS.
基于倾向性得分的重叠加权,根据基线差异进行调整,以比较整体生存率 (OS),癌症特异性生存率 (CSS) 和无复发性膀生存率 (BRFS).

主要成果:

调整后的分析表明,第二个NUR和NSS都产生了与初级NUR相比的OS,CSS和BRFS.
瘤生物学 (阶段,淋巴血管入侵,多焦点) 比复发状态或手术方法具有更大的预后影响.
由于复发的稀有性,CSS和NSS子组的统计能力有限,但趋势一致.

结论:

对逆转性UTUC复发的第二个NUR和NSS在现实环境中显示了与初级NUR相比的可比生存结果.
虽然结果是可比的,但NSS案例数量有限和相关的统计能力需要谨慎的解释.
瘤生物学是影响UTUC复发的预后的一个关键因素.

关键词:

癌症特异性生存率癌症特异性生存率反保证的复发反保证的复发节脏手术是为了节省脏.脊髓切除术 (nephroureterectomy) 是一个切除术.现实世界的证据.上部通道泌尿器官癌瘤.

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