摘要
目的 探讨大面积（直径≥3 cm）膀胱肿瘤患者经尿道膀胱肿瘤电切术（transurethral resection of the bladder tumors，TURBT）后复发的危险因素。方法 回顾性统计2008年1月到2014年9月在本科就诊的107例大面积膀胱癌患者,其中男性75例，女性32例，平均年龄67.8岁（22～90岁），行TURBT及膀胱灌注化疗，定期门诊复诊随访。根据随访期间是否复发将上述患者分为复发组和未复发组，比较两组患者在年龄、性别、BMI、吸烟史、肿瘤数量（单发或多发）、肿瘤形态（是否有蒂）、肿瘤分期和分级及是否维持膀胱灌注化疗等指标的差异，并利用单因素和多因素logistic回归统计学方法，探索大面积膀胱肿瘤TURBT术后膀胱复发的独立危险因素。结果 所有患者均成功随访。其中75例出现膀胱癌复发，32例未复发。两组患者在年龄、性别组成、BMI、吸烟史、肿瘤分期和分级及是否膀胱灌注上的差异无统计学意义。而复发组中多发、宽基底肿瘤的患者数量比例显著高于未复发组（50.7%和25.0%, 93.3% 和25.0%，P〈0.05）,多因素logistic回顾分析结果显示：肿瘤多发（95%CI：1.32～9.39,P=0.012）、宽基底（95%CI：1.50～19.84，P=0.010）是大面积膀胱肿瘤TURBT术后膀胱复发的独立危险因素。结论 与单发和有蒂肿瘤相比，多发、宽基底的大面积膀胱肿瘤TURBT术后膀胱复发的风险更高。因此，对于临床上具备上述特征的患者，有必要采取更加积极的治疗策略。
Objective To analyze risk factors of recurrence in patients with large size bladder cancer（diameter≥3 cm）after transurethral resection of bladder tumor （TURBT）.Methods The analysis included 107 patients with larger size bladder cancer.All 107 cases were identified from a prospective cohort of patients with larger size bladder tumor in our hospital between January 2008 and September 2014. There were 75 males and 32 females, with median age 67.8 years（22-90 years）.All patients were treated with TURBT and urinary bladder irrigation chemotherapy followed by regular further consultation.Patients were divided into two groups according to recurrence or not . Differences in gender, age, smoking or not, body mass index（BMI）,numbers of tumors（single or multiple）, tumor morphology （papillary or wide base）, pathological stage and grade, and the urinary bladder irrigation chemotherapy were compared between the two groups. Independent risk factors were explored by univariate and multivariate logistic regression factor analysis. Results Recurrence was observed in 75 patients, with the rate 701%.There was no significant differences in gender, age, smoking or not, pathological stage and grade, intravesical chemotherapy or not between the two groups. Number of tumors（95%CI：1.32-9.39,P=0.012）, tumor morphology（95%CI：1.50-19.84,P=0.010） were risk factors of recurrence in patients with larger size bladder cancer after TURBT. Conclusions Multiple tumors and tumors with wide base indicate higher recurrence in patients with larger size bladder cancer tumor after TURBT, they are independent risk factors for these patients.
作者
任乾
刘安伟
陈希
曾蜀雄
宋瑞祥
徐伟东
张振声
孙颖浩
许传亮
Ren Qian;Liu Anwei;Chen Xi(Department of Urology,Changhai Hospital Affiliated to Second Military Medical University,Shanghai 200438,Chin)
出处
《国际泌尿系统杂志》
2018年第4期529-532,共4页
International Journal of Urology and Nephrology
基金
上海市科技人才计划项目（17XD1404900）
关键词
膀胱肿瘤
膀胱切除术
电外科手术
肿瘤复发
局部
危险因素
Urinary Bladder Neoplasms
Cystectomy
Electrosurgery
Neoplasm Recurrence
Local
Risk Factors
