Analysis of prognostic factors in patients with transitional cell carcinoma of the bladder treated with radical cystectomy
Analysis of prognostic factors in patients with transitional cell carcinoma of the bladder treated with radical cystectomy
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DOI：
10.1590/s1677-55382006000100006
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发表时间：
2006-02-01
影响因子：
3.7
通讯作者：
Srougi, Miguel
中科院分区：
文献类型：
--
作者：
Antunes, Alberto A.;Nesrallah, Luciano J.;Srougi, Miguel
目的：分析膀胱移行细胞癌（TCC）根治性膀胱切除术的治疗结果，并确定哪些预后因素可作为无病生存率和癌症特异性生存率自变量。 材料和方法：回顾性分析 1993 年至 2005 年间接受根治性膀胱切除术和双侧髂淋巴结切除术的 113 例患者的病历。分析的危险因素包括年龄、性别、病理分期、肿瘤分级、原位癌的存在和淋巴结受累的存在。 结果：平均随访31.7+/-28.5个月后，46名患者（40.7%）出现复发，24名患者（21.2%）因癌症死亡。只有病理分期和淋巴结受累成为复发和生存的独立变量。与 T0 期患者相比，T4 期患者的疾病复发风险是 T0 期患者的 9.6 倍（p = 0.010），与无淋巴结受累的患者相比，有淋巴结受累的患者的复发风险是 2.5 倍（p = 0.047），死亡风险是无淋巴结受累的患者的 3.1 倍（p = 0.022）。 结论：病理分期和淋巴结受累代表更重要的预后变量。如果存在晚期肿瘤（T3/T4）且淋巴结受累，则应考虑进行辅助治疗。
OBJECTIVE: To analyze the results of the treatment of transitional cell carcinoma (TCC) of the bladder with radical cystectomy and determine which prognostic factors can be utilized as disease-free survival and cancer-specific survival independent variables.MATERIALS AND METHODS: Medical records of 113 patients submitted to radical cystectomy and bilateral iliac lymphadenectomy between 1993 and 2005 were reviewed. The risk factors analyzed were age, sex, pathological stage, tumor grade, presence of carcinoma in situ and the presence of lymph nodes involvement.RESULTS: After a mean follow-up of 31.7 +/- 28.5 months, 46 patients (40.7%) presented recurrence and 24 patients (21.2%) died due to cancer. Only pathological stage and the lymph nodes involvement became independent variables for recurrence and survival. Patients with T4 stage presented 9.6 times the risk of recurrence of the disease when compared with stage T0 patients (p = 0.010) and the patients with lymph node involvement presented 2.5 times the risk of recurrence (p = 0.047) and 3.1 times the risk of death (p = 0.022) when compared to patients without lymph nodes involvement.CONCLUSIONS: Pathological stage and the involvement of lymph nodes represented more important prognostic variables, and in the presence of advanced stage tumors (T3/T4) and involvement of lymph nodes, the institution of adjuvant treatment should be considered.