Sandhu Gurdarshan S, Aprikian Armen, Chin Joseph, Fradet Yves, Izawa Jonathan, Estey Eric, Fairey Adrian, Rendon Ricardo, Cagiannos Ilias, Lacombe Louis, Lattouf Jean-Baptiste, Bell David, Kassouf Wassim, Drachenberg Darrel
Washington University School of Medicine, St. Louis, MO;
Can Urol Assoc J. 2012 Jun;6(3):E116-20. doi: 10.5489/cuaj.11276.
: Radical cystectomy is the standard treatment for muscle invasive bladder cancer. We assessed clinical outcomes in patients found to have no evidence of disease (i.e., pT0N0) following radical cystectomy.
: We collected and pooled a database of 2287 patients who underwent radical cystectomy between 1993 and 2008 in eight centres across Canada. Of this number, 135 patients were found to have pT0N0 bladder cancer at the time of cystectomy. Survival data and prognostic variables were analyzed using Kaplan-Meier method and Cox proportional hazard regression analysis.
: Median patient age was 66 years with a mean follow-up of 42 months. Clinical stage distribution was Tis 8.9%, Ta 1.5%, T1 20.7%, T2 45.2%, T3 5.2%, and T4 5.2%. The five-year recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were 83%, 96%, and 88%, respectively. The 10-year RFS, DSS and OS were 66%, 92%, and 70%, respectively. On Cox proportional regression analysis, no variables were associated with disease recurrence and only patient age was associated with overall survival.
: Patients with pT0N0 pathology after cystectomy have excellent outcomes with high five- and 10-year RFS, DSS and OS. However, there is still a risk of tumour recurrence in this patient population and thus postoperative surveillance is still required.
根治性膀胱切除术是肌肉浸润性膀胱癌的标准治疗方法。我们评估了根治性膀胱切除术后未发现疾病证据（即pT0N0）患者的临床结局。
我们收集并汇总了1993年至2008年期间在加拿大八个中心接受根治性膀胱切除术的2287例患者的数据库。其中，135例患者在膀胱切除时被发现患有pT0N0膀胱癌。使用Kaplan-Meier方法和Cox比例风险回归分析对生存数据和预后变量进行分析。
患者中位年龄为66岁，平均随访42个月。临床分期分布为Tis 8.9%，Ta 1.5%，T1 20.7%，T2 45.2%，T3 5.2%，T4 5.2%。五年无复发生存率（RFS）、疾病特异性生存率（DSS）和总生存率（OS）分别为83%、96%和88%。十年RFS、DSS和OS分别为66%、92%和70%。在Cox比例回归分析中，没有变量与疾病复发相关，只有患者年龄与总生存相关。
膀胱切除术后病理为pT0N0的患者预后良好，五年和十年的RFS、DSS和OS都很高。然而，该患者群体仍有肿瘤复发的风险，因此术后仍需进行监测。
