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上尿路尿路上皮癌肾输尿管切除术后残余尿量对膀胱内复发的影响。

Impact of post-void residual urine volume on intravesical recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma.

作者信息

Sazuka Tomokazu, Sakamoto Shinichi, Nakamura Kazuyoshi, Imamura Yusuke, Yamamoto Satoshi, Komiya Akira, Ichikawa Tomohiko

机构信息

Department of Urology, Graduate School of Medicine, Chiba University, Chiba, Japan.

出版信息

Int J Urol. 2019 Dec;26(12):1106-1112. doi: 10.1111/iju.14103. Epub 2019 Sep 14.

Abstract

OBJECTIVE

To examine the impact of post-void residual urine volume on the risk of postoperative recurrence of intravesical carcinoma in patients with upper urinary tract urothelial carcinoma undergoing nephroureterectomy.

METHODS

We retrospectively reviewed the data of 81 patients who were admitted to Chiba University Graduate School of Medicine Hospital and underwent nephroureterectomy for upper urinary tract urothelial carcinoma without bladder carcinoma. We assessed the predictive factors for intravesical recurrence after nephroureterectomy in all patients. Next, we compared patients with and without a residual urine volume using propensity score-matching analysis. The presence of a residual urine volume was defined as ≥30 mL.

RESULTS

The median follow-up period among all patients was 48 months. The presence of pyuria and a residual urine volume were associated with bladder recurrence in the multivariate analysis. A total of 19 patients each were selected after matching, and we confirmed a significant difference between the presence and absence of a residual urine volume (P = 0.0291). The 2-year postoperative recurrence-free rate of patients with and without a residual urine volume was 32% and 82%, respectively.

CONCLUSIONS

This is the first study to evaluate the post-void residual urine volume and intravesical recurrence rate after nephroureterectomy for upper urinary tract urothelial carcinoma. The presence of residual urine might be a risk factor for postoperative recurrence of intravesical carcinoma.

摘要

目的

探讨上尿路尿路上皮癌患者行肾输尿管切除术后,残余尿量对膀胱内癌术后复发风险的影响。

方法

我们回顾性分析了千叶大学医学研究生院附属医院收治的81例行肾输尿管切除术治疗上尿路尿路上皮癌且无膀胱癌的患者的数据。我们评估了所有患者肾输尿管切除术后膀胱内复发的预测因素。接下来,我们使用倾向评分匹配分析比较了有和没有残余尿量的患者。残余尿量的存在定义为≥30 mL。

结果

所有患者的中位随访期为48个月。在多因素分析中,脓尿和残余尿量的存在与膀胱复发相关。匹配后各选择了19例患者,我们证实了有无残余尿量之间存在显著差异(P = 0.0291)。有和没有残余尿量的患者术后2年无复发生存率分别为32%和82%。

结论

这是第一项评估上尿路尿路上皮癌肾输尿管切除术后残余尿量和膀胱内复发率的研究。残余尿的存在可能是膀胱内癌术后复发的一个危险因素。

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