膀胱和尿道癌合并患者的肿瘤学结局
Oncological Outcomes of Patients with Concomitant Bladder and Urethral Carcinoma.
作者信息
Gakis Georgios, Efstathiou Jason A, Daneshmand Siamak, Keegan Kirk A, Clayman Rebecca H, Hrbacek Jan, Ali-El-Dein Bedeir, Zaid Harras B, Schubert Tina, Mischinger Johannes, Todenhöfer Tilman, Galland Sigolene, Olugbade Kola, Rink Michael, Fritsche Hans-Martin, Burger Maximilian, Chang Sam S, Babjuk Marko, Thalmann George N, Stenzl Arnulf, Morgan Todd M
机构信息
Department of Urology, University of Michigan, Ann Arbor, Mich., USA.
出版信息
Urol Int. 2016;97(2):134-41. doi: 10.1159/000448335. Epub 2016 Jul 28.
INTRODUCTION
The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (BC) and urethral carcinoma.
METHODS
This is a multicenter series of 110 patients (74 men, 36 women) diagnosed with urethral carcinoma at 10 referral centers between 1993 and 2012. Kaplan-Meier analysis was used to investigate the impact of BC on survival, and Cox regression multivariable analysis was performed to identify predictors of recurrence.
RESULTS
Synchronous BC was diagnosed in 13 (12%) patients, and the median follow-up was 21 months (interquartile range 4-48). Urethral cancers were of higher grade in patients with synchronous BC compared to patients with non-synchronous BC (p = 0.020). Patients with synchronous BC exhibited significantly inferior 3-year recurrence-free survival (RFS) compared to patients with non-synchronous BC (63.2 vs. 34.4%; p = 0.026). In multivariable analysis, inferior RFS was associated with clinically advanced nodal stage (p < 0.001), proximal tumor location (p < 0.001) and synchronous BC (p = 0.020).
CONCLUSION
The synchronous presence of BC in patients diagnosed with urethral carcinoma has a significant adverse impact on RFS and should be an impetus for a multimodal approach.
引言
本研究旨在调查合并膀胱癌（BC）和尿道癌患者的肿瘤学结局。
方法
这是一项多中心研究，纳入了1993年至2012年间在10个转诊中心诊断为尿道癌的110例患者（74例男性，36例女性）。采用Kaplan-Meier分析来研究BC对生存的影响，并进行Cox回归多变量分析以确定复发的预测因素。
结果
13例（12%）患者诊断为同步BC，中位随访时间为21个月（四分位间距4 - 48）。与非同步BC患者相比，同步BC患者的尿道癌分级更高（p = 0.020）。与非同步BC患者相比，同步BC患者的3年无复发生存率（RFS）显著更低（63.2%对34.4%；p = 0.026）。在多变量分析中，较差的RFS与临床晚期淋巴结分期（p < 0.001）、肿瘤近端位置（p < 0.001）和同步BC（p = 0.020）相关。
结论
诊断为尿道癌的患者中同步存在BC对RFS有显著不利影响，应促使采用多模式治疗方法。
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