Hofner Thomas, Haferkamp Axel, Knapp Lena, Pahernik Sascha, Hadaschik Boris, Djakovic Nenad, Wagener Nina, Hohenfellner Markus
Department of Urology, University of Heidelberg, Heidelberg, Germany.
Urol Int. 2011;86(1):25-30. doi: 10.1159/000321008. Epub 2010 Nov 2.
Hydronephrosis and BMI are analyzed together with established factors such as TNM stage and surgical margins in a multivariate modality to investigate their status as independent prognostic factors for bladder cancer-specific survival in patients undergoing radical cystectomy.
We studied a prospective cohort of 328 patients who underwent radical cystectomy for bladder cancer at our institution. Statistical analyses were performed using the Kaplan-Meier method, Kendall-tau rank correlation and multivariate Cox proportional hazard model.
Hydronephrosis was positively correlated with advanced tumor stage, positive lymph node involvement and positive surgical margins. Adjusted for all other investigated parameters, BMI and hydronephrosis did not affect cancer-specific survival. In multivariate analysis only non-organ-confined disease (HR: 1.40, 95% CI: 1.04-1.87, p = 0.024), positive lymph node stage (HR 1.71: 95% CI: 1.12-2.61, p = 0.013) and positive surgical margins (HR 3.00, 95% CI: 1.74-5.15, p < 0.001) were prognostic factors.
Hydronephrosis at the time of radical cystectomy is significantly correlated with the presence of more advanced bladder cancer and positive surgical margins. However, the long-established parameters pT stage, pN stage and surgical margins predominantly influence cancer-specific survival for patients undergoing radical cystectomy irrespective of hydronephrosis and BMI status.
肾积水和体重指数（BMI）与TNM分期和手术切缘等既定因素一起，采用多变量分析方法进行分析，以研究它们作为接受根治性膀胱切除术患者膀胱癌特异性生存独立预后因素的状况。
我们研究了在我院接受膀胱癌根治性膀胱切除术的328例患者的前瞻性队列。采用Kaplan-Meier法、Kendall-tau秩相关和多变量Cox比例风险模型进行统计分析。
肾积水与肿瘤晚期、阳性淋巴结受累和阳性手术切缘呈正相关。在对所有其他研究参数进行校正后，BMI和肾积水不影响癌症特异性生存。多变量分析中，只有非器官局限性疾病（HR：1.40，95%CI：1.04-1.87，p = 0.024）、阳性淋巴结分期（HR 1.71：95%CI：1.12-2.61，p = 0.013）和阳性手术切缘（HR 3.00，95%CI：1.74-5.15，p < 0.001）是预后因素。
根治性膀胱切除术时的肾积水与更晚期膀胱癌的存在和阳性手术切缘显著相关。然而，长期以来确定的参数pT分期、pN分期和手术切缘主要影响接受根治性膀胱切除术患者的癌症特异性生存，而与肾积水和BMI状况无关。
