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接受根治性膀胱切除术治疗的肌层浸润性膀胱尿路上皮癌患者条件生存的预后因素。

Prognostic factors for conditional survival in patients with muscle-invasive urothelial carcinoma of the bladder treated with radical cystectomy.

作者信息

Kang Minyong, Kim Hyung Suk, Jeong Chang Wook, Kwak Choel, Kim Hyeon Hoe, Ku Ja Hyeon

机构信息

Department of Urology, Seoul National University Bundang Hospital, Seongnam, Kyeonggi-do.

Department of Urology, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Sci Rep. 2015 Jul 27;5:12171. doi: 10.1038/srep12171.

Abstract

Because only a few studies have evaluated conditional survival (CS) in bladder cancer patients, we examined conditional overall survival (OS) and cancer-specific survival (CSS) in these patients after radical cystectomy (RC), and determined which prognostic variables affect CS over time. We reviewed 487 patients treated with RC and pelvic lymph node dissection at our institution between 1991 and 2012. Cox regression models were used to identify the significant prognostic factors for CS depending on clinicopathological characteristics. As survival time increased after RC, conditional OS and CSS rates increased when compared with baseline survival probability. CS more significantly improved in the patients with unfavorable pathologic characteristics. While many variables were associated with survival at baseline, only age was found to be a significant prognostic factor for 5-year conditional OS in all given survivorships. In conclusion, conditional OS and CSS probabilities significantly improved over time, with greater improvements in the cases with unfavorable pathologic features. Moreover, age remained the key prognostic factor for conditional OS estimates from baseline to 5 years after surgery. Our results provide practical survival information to guide adjustments in our current follow-up strategy for bladder cancer patients after RC.

摘要

由于仅有少数研究评估了膀胱癌患者的条件生存(CS)情况,我们对这些患者在根治性膀胱切除术(RC)后的条件总生存(OS)和癌症特异性生存(CSS)进行了研究,并确定了哪些预后变量随时间影响CS。我们回顾了1991年至2012年间在我们机构接受RC及盆腔淋巴结清扫术治疗的487例患者。采用Cox回归模型根据临床病理特征确定CS的显著预后因素。随着RC后生存时间的延长,与基线生存概率相比,条件OS和CSS率有所增加。病理特征不利的患者CS改善更为显著。虽然许多变量在基线时与生存相关,但在所有给定的生存期内,仅年龄被发现是5年条件OS的显著预后因素。总之,条件OS和CSS概率随时间显著改善,病理特征不利的病例改善更大。此外,年龄仍然是从基线到术后5年条件OS估计的关键预后因素。我们的结果提供了实用的生存信息,以指导我们当前对RC后膀胱癌患者随访策略的调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f484/4515743/30885bad9f81/srep12171-f1.jpg

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