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| 根治性膀胱切除术前最大限度经尿道膀胱肿瘤切除术对膀胱多发肿瘤患者预后的影响分析 |
| Analysis of the Impact of Maximal Transurethral Resection of Bladder Tumor (TURBT) Prior to Radical Cystectomy (RC) on the Prognosis of Patients with Multiple Bladder Tumors |
| 投稿时间：2025-01-22 修订日期：2025-05-21 |
| DOI： |
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| 中文关键词: 根治性膀胱切除术 经尿道膀胱肿瘤切除术 膀胱多发肿瘤 预后生存 影响因素 最大限度 |
| 英文关键词:radical cystectomy transurethral resection of bladder tumor multiple bladder tumors prognosis and survival influencing factors maximum limit |
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| 中文摘要: |
| 目的:探究根治性膀胱切除(RC)术前最大限度经尿道膀胱肿瘤切除术(TURBT)对膀胱多发肿瘤患者预后的影响分析。方法:回顾性分析2015年6月至2018年6月我院收治184例膀胱多发肿瘤患者临床资料。依据TURBT切除范围,将其分为最大限度组(112例)及诊断性电切组(72例),比较两组生存时间、术后1年、3年及5年总生存率及无复发生存率。再依据术后5年是否存活,将其分为死亡组(48例)及存活组(136例),比较两组一般资料,采用Cox分析RC术前行最大限度TURBT对膀胱多发肿瘤患者生存预后的相关影响因素,采用KM生存曲线分析患者生存率。结果:最大限度组生存时间、术后1年、3年及5年总生存率及无复发生存率均显著高于诊断性电切组(P<0.05)。性别、年龄、肿瘤直径、肿瘤级别及淋巴结清扫与患者预后无关(P>0.05)。病理分期、肿瘤数量、手术类型、淋巴结转移、术前新辅助化疗及ECOG评分是患者术后5年生存的影响因素(P<0.05)。Cox回归结果显示,肿瘤数量2处及术前新辅助化疗是患者死亡的独立保护因素(P<0.05)；淋巴结转移及ECOG评分高是患者死亡的独立危险因素(P<0.05)。KM曲线分析结果显示,对于肿瘤数量、淋巴结转移、术前新辅助化疗及ECOG评分不同级别,Log-rank检验的显著性值均P<0.05,生存差异显著。结论:最大限度TURBT术在RC术前对膀胱多发肿瘤患者的预后具有显著影响,能够显著提高生存时间及生存率。 |
| 英文摘要: |
| Objective:To investigate the impact of maximal transurethral resection of bladder tumor (TURBT) prior to radical cystectomy (RC) on the prognosis of patients with multiple bladder tumors. Methods: A retrospective analysis was conducted on the clinical data of 184 patients with multiple bladder tumors admitted to our hospital from June 2015 to June 2018. Based on the extent of TURBT resection, the patients were divided into a maximal group (112 patients) and a diagnostic transurethral resection (TUR) group (72 patients). The survival time, overall survival rates, and recurrence-free survival rates at 1, 3, and 5 years after surgery were compared between the two groups. Additionally, the patients were divided into a deceased group (48 patients) and a surviving group (136 patients) based on their survival status at 5 years after surgery. General patient information was compared between the two groups, and Cox analysis was used to assess the relevant factors influencing the survival prognosis of patients with multiple bladder tumors who underwent maximal TURBT prior to RC. Kaplan-Meier (KM) survival curves were used to analyze patient survival rates. Results: The maximal group had significantly longer survival times and higher overall survival and recurrence-free survival rates at 1, 3, and 5 years after surgery compared to the diagnostic TUR group (P<0.05). Gender, age, tumor diameter, tumor grade, and lymph node dissection were not associated with patient prognosis (P>0.05). Pathological stage, tumor number, surgical type, lymph node metastasis, preoperative neoadjuvant chemotherapy, and ECOG score were factors influencing patient survival at 5 years after surgery (P<0.05). Cox regression results showed that a tumor number of 2 and preoperative neoadjuvant chemotherapy were independent protective factors for patient mortality (P<0.05), while lymph node metastasis and a high ECOG score were independent risk factors for patient mortality (P<0.05). KM curve analysis results showed that for different levels of tumor number, lymph node metastasis, preoperative neoadjuvant chemotherapy, and ECOG score, the significance values of the Log-rank test were all P<0.05, indicating significant differences in survival. Conclusion: Maximal TURBT prior to RC has a significant impact on the prognosis of patients with multiple bladder tumors, significantly improving survival time and survival rates. |
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