Babiker A, Shearer R J, Chilvers C E
Royal Marsden Hospital, London, UK.
Br J Cancer. 1989 Mar;59(3):441-4. doi: 10.1038/bjc.1989.90.
Information on primary tumour size, status of the pelvic lymph nodes, histological type and macroscopic tumour appearance, as well as age and sex, was available at presentation for 394 patients in the Co-operative Urological Cancer Group's prospective randomised trial for T3 cancer of the urinary bladder. An apparently significant prognostic effect of age and sex was shown to be entirely consistent with the effect of natural mortality. Primary tumour size was found to be the single most powerful prognostic factor (P = 0.002), followed by nodal status (P = 0.02). These factors do not act independently. Multivariate analysis showed that 75% of the effect of all the six variables and their first order interactions could be explained by a single prognostic grouping based on tumour size and nodal status only. Three levels for this grouping are proposed: node-negative small tumour, node-negative moderate tumour and either node-positive or large tumour. The 3-year survival probabilities for the three prognostic groups were 85.7% (95% CI 57.2 and 96.4%), 60.3% (48.0 and 71.5%) and 33.3% (23.5 and 44.8%) respectively.
在合作性泌尿生殖系统癌症小组针对膀胱T3期癌症的前瞻性随机试验中，394例患者在初诊时可获取有关原发肿瘤大小、盆腔淋巴结状态、组织学类型和肿瘤大体外观的信息，以及年龄和性别信息。年龄和性别明显的预后影响被证明与自然死亡率的影响完全一致。发现原发肿瘤大小是最有力的单一预后因素（P = 0.002），其次是淋巴结状态（P = 0.02）。这些因素并非独立起作用。多变量分析表明，所有六个变量及其一阶相互作用的75%的影响可以仅基于肿瘤大小和淋巴结状态的单一预后分组来解释。为此分组提出了三个级别：淋巴结阴性小肿瘤、淋巴结阴性中等肿瘤以及淋巴结阳性或大肿瘤。三个预后组的3年生存概率分别为85.7%（95%可信区间57.2和96.4%）、60.3%（48.0和71.5%）和33.3%（23.5和44.8%）。
