Department of Urologic Surgery, Tianjin Medical University Second Hospital, Tianjin, China.
Department of Radiology, Tianjin Medical University Second Hospital, Tianjin, China.
Eur J Surg Oncol. 2019 Oct;45(10):1993-1999. doi: 10.1016/j.ejso.2019.07.018. Epub 2019 Jul 16.
This study sought to identify factors associated with survival of pT1 urothelial carcinoma of bladder (UCB) after radical cystectomy (RC).
This study consists of 114 pT1 UCB [primary 83, recurrent 31, none were amenable to transurethral resection (TUR)] treated by radical cystectomy. Survival analysis using Cox regression tests were performed to identify factors associated with survival of pT1 UCB after RC.
Pelvic lymph node (LN) status, age and lymphovascular invasion (LVI) are associated with survival of pT1 UCB after RC; recurrent pT1 UCB of high grade origin (HGO) tends to have poorer CSS than primary pT1 UCB or recurrent pT1 UCB of low grade origin (LGO) (5-year and 10-year CSS rates was 75% and 73% for primary cases; 77% and 77% for recurrent pT1 UCB of LGO; and 56% and 37% for recurrent pT1 UCB of HGO, p = 0.078).
LN status, age and LVI were significantly associated with survival of pT1 UCB after RC. Recurrent pT1 UCB of HGO should be managed with radical cystectomy in a timely fashion given that these cases tend to have poorer CSS than primary pT1 UCB after RC, even if they did not progress to muscle-invasive bladder cancer (MIBC).
本研究旨在确定与根治性膀胱切除术（RC）后 pT1 膀胱尿路上皮癌（UCB）生存相关的因素。
本研究包括 114 例 pT1 UCB [原发性 83 例，复发性 31 例，均不可行经尿道切除术（TUR）]接受 RC 治疗。采用 Cox 回归检验进行生存分析，以确定与 RC 后 pT1 UCB 生存相关的因素。
盆腔淋巴结（LN）状态、年龄和脉管侵犯（LVI）与 RC 后 pT1 UCB 的生存相关；高级别起源的复发性 pT1 UCB（HGO）的 CSS 倾向于比原发性 pT1 UCB 或低级别起源的复发性 pT1 UCB（LGO）更差（5 年和 10 年 CSS 率分别为原发性病例的 75%和 73%；LGO 的复发性 pT1 UCB 为 77%和 77%；HGO 的复发性 pT1 UCB 为 56%和 37%，p=0.078）。
LN 状态、年龄和 LVI 与 RC 后 pT1 UCB 的生存显著相关。由于这些病例在 RC 后 CSS 倾向于比原发性 pT1 UCB 更差，即使它们没有进展为肌层浸润性膀胱癌（MIBC），HGO 的复发性 pT1 UCB 也应及时进行 RC 治疗。
