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941 例非肌层浸润性膀胱癌经尿道切除术后即刻应用丝裂霉素 C 灌洗的时间效应。

The effect of timing of an immediate instillation of mitomycin C after transurethral resection in 941 patients with non-muscle-invasive bladder cancer.

机构信息

Department of Urology, VU university Medical Center, Amsterdam, The Netherlands.

Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

BJU Int. 2018 Oct;122(4):571-575. doi: 10.1111/bju.14124. Epub 2018 Jan 31.

Abstract

OBJECTIVE

To investigate whether the timing of an immediate instillation of mitomycin C (on the day of transurethral resection of bladder tumour [TURBT] or 1 day later) has an impact on time to recurrence of non-muscle-invasive bladder cancer (NMIBC).

PATIENTS AND METHODS

All patients with NMIBC who were enrolled in a prospective trial between 1998 and 2003, and treated with an early mitomycin C instillation (on the day of TURBT or 1 day later), were selected. Statistical analysis was performed with Kaplan-Meier curves and multivariable Cox regression.

RESULTS

Administering an instillation of mitomycin C on the day of TURBT or 1 day later did not show a statistically significant difference in time to recurrence in a univariable model (log-rank P = 0.99). After correcting for the number of scheduled adjuvant instillations, no statistically significant difference could be detected either: hazard ratio 1.05 (95% confidence interval 0.81-1.35, P = 0.74).

CONCLUSION

These data do not support the hypothesis that a very early instillation (on the day of TURBT) of mitomycin C decreases the risk of recurrence as compared with an early instillation (1 day after TURBT).

摘要

目的

研究即刻给予丝裂霉素 C 灌注(在经尿道膀胱肿瘤切除术 [TURBT] 当天或第 1 天)的时机是否会影响非肌层浸润性膀胱癌(NMIBC)的复发时间。

患者与方法

选择了 1998 年至 2003 年期间参加前瞻性试验并接受早期丝裂霉素 C 灌注(在 TURBT 当天或第 1 天)治疗的所有 NMIBC 患者。采用 Kaplan-Meier 曲线和多变量 Cox 回归进行统计分析。

结果

在单变量模型中,在 TURBT 当天或第 1 天给予丝裂霉素 C 灌注在复发时间上没有统计学显著差异(对数秩 P = 0.99)。在对计划辅助灌注次数进行校正后,也未发现统计学显著差异:风险比 1.05(95%置信区间 0.81-1.35,P = 0.74)。

结论

这些数据不支持即刻(TURBT 当天)给予丝裂霉素 C 灌注比早期(TURBT 后第 1 天)灌注可降低复发风险的假设。

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