Department of Urology, Huashan Hospital, Fudan University, No. 12, WuLuMuQi Middle Road, Shanghai, China.
Int Urol Nephrol. 2013 Feb;45(1):107-11. doi: 10.1007/s11255-012-0305-y. Epub 2012 Oct 6.
To investigate whether there is a difference between urachal and non-urachal adenocarcinomas in terms of patient survival and to determine the significant prognostic factors.
Thirty-four patients with histologically proven adenocarcinoma of the urinary bladder were treated at Huashan hospital between 1999 and 2010. 13 cases were excluded, including 12 patients with metastatic involvement from gastrointestinal or reproductive tracts and one without follow-up data after the initial consultation. Life tables, Kaplan-Meier, Cox regression analysis and log-rank test were used.
The difference between patients with urachal adenocarcinoma and patients with non-urachal adenocarcinoma was not statistically significant using the Kaplan-Meier estimates (P = 0.0763). Clinical stage had a significant influence on survival (P = 0.0320, Fig. 2). Patients with surgical resection including partial and radical cystectomy did not have a better prognosis (P = 0.7992, Fig. 3). However, the difference is statistically significant between patients who received partial cystectomy and patients who received radical cystectomy (P = 0.0123, Fig. 4).
Survival of Patients with adenocarcinoma is correlated with clinical stage. Patients with urachal adenocarcinoma and non-urachal adenocarcinoma may have similar survival outcome. Tumor stage was a highly significant predictor of outcome (P = 0.0320). Surgical resection seems to be more important than chemotherapy in the cases of adenocarcinoma of the urinary bladder. We are in favor of radical cystectomy for all patients.
探讨脐尿管腺癌与非脐尿管腺癌患者在生存方面是否存在差异,并确定其显著的预后因素。
回顾性分析 1999 年至 2010 年期间在华山医院接受治疗且经组织学证实的 34 例膀胱腺癌患者的临床资料。排除 13 例患者,包括 12 例转移性胃肠道或生殖系统腺癌患者和 1 例初始就诊后无随访数据的患者。采用生存表、Kaplan-Meier 法、Cox 回归分析和对数秩检验进行数据分析。
Kaplan-Meier 估计表明,脐尿管腺癌患者与非脐尿管腺癌患者之间的差异无统计学意义(P = 0.0763)。临床分期对生存有显著影响(P = 0.0320,图 2)。接受包括部分和根治性膀胱切除术的手术切除的患者预后并无明显改善(P = 0.7992,图 3)。然而,部分膀胱切除术和根治性膀胱切除术患者之间的差异有统计学意义(P = 0.0123,图 4)。
患者的生存与临床分期相关。脐尿管腺癌和非脐尿管腺癌患者的生存结果可能相似。肿瘤分期是影响预后的高度显著因素(P = 0.0320)。在膀胱腺癌病例中,手术切除似乎比化疗更为重要。我们建议对所有患者行根治性膀胱切除术。