Prognostic Value of Renin-Angiotensin System Blockade in Non-muscle-invasive Bladder Cancer
Prognostic Value of Renin-Angiotensin System Blockade in Non-muscle-invasive Bladder Cancer
复制标题
DOI：
10.1245/s10434-012-2568-z
复制
发表时间：
2012-11-01
影响因子：
3.7
通讯作者：
Oya, Mototsugu
中科院分区：
文献类型：
--
作者：
Yuge, Kazuyuki;Miyajima, Akira;Oya, Mototsugu
为确定使用血管紧张素转换酶抑制剂（ACEIs）或血管紧张素II受体阻滞剂（ARB）等肾素-血管紧张素系统（RAS）抑制剂是否影响非肌层浸润性膀胱癌（NMIBC）的疾病结局，共确定了330例初诊NMIBC患者。我们回顾性研究了接受或未接受RAS抑制剂治疗的患者经尿道膀胱肿瘤切除术（TUR-BT）后的临床结局。中位随访时间为4.1年，共有128例患者（38.8%）发生了后续肿瘤复发，17例患者（5.2%）在随访期间观察到分期进展。51例患者（15.5%）在经尿道切除术时接受了ACEI或ARB给药。多因素分析显示，肿瘤多样性、未接种卡介苗、静脉滴注、未使用ACEI或ARB（P = 0.010，风险比2.26）是肿瘤复发的独立危险因素。接受ACEI或ARB治疗的患者的5年无复发生存率为78.4%，而接受ACEI或ARB治疗的患者的5年无复发生存率为53.3%（P = 0.011）。在最初诊断为NMIBC的患者中，未接受RAS抑制剂治疗是随后肿瘤复发的独立风险因素。我们的数据支持进一步研究RAS抑制剂作为降低NMIBC肿瘤复发的潜在疗法的作用。
To determine whether the administration of renin-angiotensin system (RAS) inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), affect disease outcome in non-muscle-invasive bladder cancer (NMIBC).A total of 330 patients with initially diagnosed NMIBC were identified. We retrospectively investigated the clinical outcomes after transurethral resection of bladder tumor (TUR-BT) in patients who did or did not receive RAS inhibitors. The median follow-up period was 4.1 years.A total of 128 patients (38.8 %) experienced subsequent tumor recurrence, and stage progression was observed in 17 patients (5.2 %) during follow-up. Fifty-one patients (15.5 %) had received ACEI or ARB administration at transurethral resection. Multivariate analysis demonstrated that tumor multiplicity, absence of bacillus Calmette-Gu,rin instillation, and no administration of ACEI or ARB (P = 0.010, hazard ratio 2.26) were independent risk factors for subsequent tumor recurrence. The 5-year recurrence-free survival rate was 78.4 % in patients administered ACEIs or ARBs, and 53.3 % in their counterparts (P = 0.011).The absence of RAS inhibitor administration was an independent risk factor for subsequent tumor recurrence in patients with initially diagnosed NMIBC. Our data support further investigation of the role of RAS inhibitors as a potential therapy to decrease tumor recurrence in NMIBC.