Şefik Ertuğrul, Çelik Serdar, Günlüsoy Bülent, Basmacı İsmail, Yarımoğlu Serkan, Bozkurt İbrahim Halil, Değirmenci Tansu, Dinçel Çetin
Department of Urology, Health Sciences University, Bozyaka Training and Research Hospital, İzmir, Turkey.
Turk J Urol. 2019 Dec;45(Supp. 1):S49-S55. doi: 10.5152/tud.2019.09515. Epub 2019 Apr 3.
The aim of the present study was to evaluate the influence of preoperative hydronephrosis and ureteral orifice involvement (UOI) on survival of patients undergoing radical cystectomy (RC) for bladder cancer (BC).
A total of 162 patients with BC underwent RC between January 2006 and March 2017. Patients were divided into two groups for both presences of preoperative hydronephrosis and orifice involvement at final pathology. Additionally, tumors with orifice involvement were subgrouped histopathologically after RC as those with only UOI and those with invasive to the ureter with an additional concurrent site at final pathology.
Preoperative hydronephrosis was detected in 57 patients. Preoperative and postoperative creatinine on month 3 were higher in the preoperative hydronephrosis (+) group (p<0.001). In addition, postoperative T stage, surgical margin positivity, invasion of urethra, and pathological upstaging were higher in this group. Cancer-specific survival (CSS) and overall survival (OS) were better in the hydronephrosis (-) group than in the hydronephrosis (+) group (p=0.001 and p=0.001, respectively). Preoperative hydronephrosis was found to be an independent factor in pathological upstaging. Patients were divided into two groups according to the presence of UOI. Group 1 consisted of patients without UOI, and group 2 with UOI. Preoperative hydronephrosis, hydronephrosis grade, and T stage were statistically higher in tumors with UOI. Moreover, CSS and OS were lower in group 2 than in group 1.
Preoperative hydronephrosis and UOI are predicting factors on survival of patients undergoing RC for BC. Preoperative hydronephrosis was found to be an independent factor in pathological upstaging.
本研究旨在评估术前肾积水及输尿管口受累（UOI）对膀胱癌（BC）患者行根治性膀胱切除术（RC）后生存的影响。
2006年1月至2017年3月期间，共有162例BC患者接受了RC。根据术前肾积水情况及最终病理检查时输尿管口受累情况，将患者分为两组。此外，对RC术后输尿管口受累的肿瘤进行组织病理学亚组分析，分为仅输尿管口受累组和最终病理检查时输尿管受侵且有其他并发部位组。
57例患者检测到术前肾积水。术前肾积水（+）组患者术前及术后3个月的肌酐水平较高（p<0.001）。此外，该组患者术后T分期、手术切缘阳性率、尿道侵犯及病理分期上调情况均较高。肾积水（-）组的癌症特异性生存（CSS）和总生存（OS）均优于肾积水（+）组（分别为p=0.001和p=0.001）。术前肾积水被发现是病理分期上调的独立因素。根据UOI情况将患者分为两组。第1组为无UOI的患者，第2组为有UOI的患者。有UOI的肿瘤患者术前肾积水、肾积水分级及T分期在统计学上更高。此外，第2组的CSS和OS低于第1组。
术前肾积水和UOI是BC患者行RC后生存的预测因素。术前肾积水被发现是病理分期上调的独立因素。
