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根治性肾输尿管切除术治疗输尿管尿路上皮癌患者中肿瘤位置和表浅性尿路上皮膀胱癌病史的预后意义。

Prognostic significance of tumor location and superficial urothelial bladder carcinoma history in patients with ureteral urothelial carcinoma treated with radical nephroureterectomy.

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, People's Republic of China.

出版信息

Int Urol Nephrol. 2013 Apr;45(2):395-404. doi: 10.1007/s11255-013-0398-y. Epub 2013 Feb 14.

DOI:10.1007/s11255-013-0398-y
PMID:23408324
Abstract

PURPOSE

To investigate the significance of tumor location and superficial urothelial bladder carcinoma (UBC) history on oncological outcomes in patients treated with radical nephroureterectomy (RNU) for ureteral urothelial carcinoma (UC).

METHODS

One hundred and thirty-two patients treated with RNU for ureteral UC between January 1999 and July 2010 were retrospectively analyzed. Recurrence probabilities and survival rates were analyzed, stratified by tumor location and superficial UBC history.

RESULTS

Comparison of patients with proximal, middle, and distal ureteral UC showed that percentage of bladder recurrence was 13.3, 14.7, and 25.0 %, respectively (P = 0.285); retroperitoneal (tumor bed or lymph node) recurrence was 26.7, 14.7, and 27.9 % (P = 0.319); and contralateral recurrence was 0, 2.9, and 0 % (P = 0.234). Comparison of patients with and without history of superficial UBC revealed that percentage of bladder recurrence was 15.4 and 20.2 %, respectively (P = 0.681); retroperitoneal recurrence was 15.4 and 25.2 % (P = 0.433); and contralateral recurrence was 0 and 0.84 % (P = 0.740). Using multivariable Cox regression analyses, there were no significant differences of recurrence-free survival (RFS) and cancer-specific survival (CSS) with regard to neither tumor location nor superficial UBC history (RFS: P = 0.282 and 0.762, CSS: P = 0.272 and 0.818, respectively).

CONCLUSIONS

Tumor location and history of superficial UBC could not be used to predict oncological outcomes of patients who underwent RNU for ureteral UC. Therefore, operative strategies or postoperative surveillance should not be affected by tumor location or history of superficial UBC.

摘要

目的

探讨肿瘤位置和表浅性尿路上皮膀胱癌(UBC)病史对接受根治性肾输尿管切除术(RNU)治疗输尿管尿路上皮癌(UC)患者的肿瘤学结果的意义。

方法

回顾性分析了 1999 年 1 月至 2010 年 7 月期间接受 RNU 治疗的 132 例输尿管 UC 患者。根据肿瘤位置和表浅性 UBC 病史,分析复发概率和生存率。

结果

近端、中段和远端输尿管 UC 患者的比较显示,膀胱复发率分别为 13.3%、14.7%和 25.0%(P=0.285);腹膜后(肿瘤床或淋巴结)复发率分别为 26.7%、14.7%和 27.9%(P=0.319);对侧复发率分别为 0、2.9%和 0%(P=0.234)。有和无表浅性 UBC 病史患者的比较显示,膀胱复发率分别为 15.4%和 20.2%(P=0.681);腹膜后复发率分别为 15.4%和 25.2%(P=0.433);对侧复发率分别为 0 和 0.84%(P=0.740)。使用多变量 Cox 回归分析,肿瘤位置和表浅性 UBC 病史与无复发生存率(RFS)和癌症特异性生存率(CSS)均无显著差异(RFS:P=0.282 和 0.762,CSS:P=0.272 和 0.818)。

结论

肿瘤位置和表浅性 UBC 病史不能用于预测接受 RNU 治疗输尿管 UC 患者的肿瘤学结果。因此,手术策略或术后监测不应受肿瘤位置或表浅性 UBC 病史的影响。

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