摘要
目的分析保留膀胱手术对膀胱癌复发发生率的影响,并探讨复发的危险因素。方法选取2020年1月—2022年1月龙岩市第一医院泌尿外科收治的接受保留膀胱手术治疗的初发膀胱癌患者200例;患者均接受为期1年时间的随访观察,对其一般资料、术后治疗方案、肿瘤学特征及术后复发情况进行观察记录。根据患者1年内的复发情况,将全部患者分为高复发组(1年内复发次数≥2次,HR组)、低复发组(1年内复发1次,LR组)及无复发组(NR组);另根据复发后肿瘤分级有无改变将低级别肿瘤复发患者分为进展组与无进展组。对患者临床特征进行比较。结果200例患者中,110例患者无复发;90例患者复发,复发率为45.0%(90/200),其中LR组、HR组分别为56例、34例。三组的术前吸烟史、肿瘤分期、肿瘤分级、肿瘤数目、术后行规范化膀胱灌注化疗、术后接受干扰素治疗比例比较,差异有统计学意义(P<0.05)。在肿瘤分期、术前吸烟史方面,进展组与无进展组比较,差异有统计学意义(P<0.05)。结论膀胱癌患者采用保留膀胱手术治疗的术后复发风险较高,而术后复发的危险因素包括肿瘤多发、肿瘤分期、肿瘤分级、术前吸烟史、术后未进行膀胱灌注化疗;对于术后复发的膀胱癌患者来讲,术后继续吸烟、初发肿瘤分期较高会导致肿瘤分级增加,术后戒烟能让术后复发风险降低。
Objective To analyze the effect of bladder-sparing surgery on the incidence of bladder cancer recurrence and to explore the risk factors of recurrence.Methods From January 2020 to January 2022,a total of 200 patients with primary bladder cancer who received bladder conserving surgery in the department of urology of Longyan First Hospital were selected.Patients underwent a one-year follow-up observation,and their general information,postoperative treatment plan,oncological characteristics,and postoperative recurrence were observed and recorded.According to the recurrence rate within one year,all patients were divided into a high recurrence group(HR group with≥2 recurrences within one year),a low recurrence group(LR group with 1 recurrence within one year),and a non recurrence group(NR group).Furthermore,patients with low-level tumor recurrence were divided in t o progressive and non progressive groups based on whether there was any change in tumor grading after recurrence.The clinical features of patients were compared.Results Among the 200 patients,a total of 110 patients had no recurrence;90 patients had a recurrence rate of 45.0%(90/200),there were 56 cases in LR group and 34 cases in HR group.Interms of tumor stage and preoperative smoking history,there was significant differences between progression group and no progression group(P<0.05).Conclusion For bladder cancer patients with bladder sparing surgery,the risk factors of postoperative recurrence include tumor occurrence,tumor stage,tumor grade,preoperative smoking history,and no postoperative bladder perfusion chemotherapy.For postoperative bladder cancer patients,postoperative smoking and higher primary tumor stage,and postoperative smoking cessation can reduce the risk of postoperative recurrence.
作者
肖锬
李警
易熠
XIAO Tan;LI Jing;YI Yi(Department of Urology,Longyan First Hospital,Longyan Fujian 366300,China)
出处
《中国卫生标准管理》
2023年第15期105-109,共5页
China Health Standard Management
关键词
保留膀胱手术
膀胱癌
复发
肿瘤学特征
肿瘤分级
危险因素
bladder preservation surgery
bladder cancer
recurrence
oncological characteristics
tumor grading
risk factors
