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分析年龄对非肌肉浸润性膀胱癌卡介苗免疫治疗的肿瘤学结果和毒性的影响。

Analysis of age influence on oncological results and toxicity of BCG immunotherapy in non-muscle invasive bladder cancer.

机构信息

Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland.

Department of Urology, Fundacion Puigvert, Autonomous University of Barcelona, Carrer de Cartagena, 340-350, 08025, Barcelona, Spain.

出版信息

World J Urol. 2020 Dec;38(12):3177-3182. doi: 10.1007/s00345-020-03130-1. Epub 2020 Feb 18.

Abstract

PURPOSE

The aim of this study was to analyse the influence of age on the treatment outcome and toxicity in patients with T1HG non-muscle invasive bladder cancers treated with BCG immunotherapy.

METHODS

Data from 637 patients with primary T1HG bladder cancer who were treated between 1986 and 2016 in two academic centres were retrospectively reviewed. Median follow-up was 57 months. Patients were divided into two groups: younger (< 70 years old) and older (≥ 70 years old). Additional analyses in subgroups of older (> 75 and > 80) patients were performed. Log-rank test, Cox regression analysis, and propensity score matching were performed to compare the groups.

RESULTS

There were 389 patients below and 248 patients above or equal 70 years old. Recurrence-free, progression-free, and cancer-specific survival rates did not differ significantly between younger and older patients. Recurrence-free survival for younger and older patients were 55.4% vs 52.9%, progression-free survival 75.9% vs 76.6%, and cancer-specific survival were 87.5% vs 89.9% (all p > 0.05). Differences in the oldest subgroups also did not reach statistical significance. In both regression analysis and propensity score matching, no statistically significant associations of age with any of analysed end-points were found. Finally, there were no statistically significant differences between younger and older group in terms of moderate and severe complications occurrence (47.6% vs. 44.5%; p > 0.05) CONCLUSIONS: It was shown that increasing age was not associated with BCG immunotherapy oncological outcomes, or with BCG toxicity in T1HG non-muscle invasive bladder cancer.

摘要

目的

本研究旨在分析年龄对接受卡介苗免疫治疗的 T1HG 非肌肉浸润性膀胱癌患者治疗结果和毒性的影响。

方法

回顾性分析了 1986 年至 2016 年在两个学术中心接受治疗的 637 例原发性 T1HG 膀胱癌患者的数据。中位随访时间为 57 个月。患者分为两组:年轻组(<70 岁)和老年组(≥70 岁)。对老年组(>75 岁和>80 岁)进行了亚组分析。采用对数秩检验、Cox 回归分析和倾向评分匹配比较两组。

结果

年龄<70 岁的患者 389 例,年龄≥70 岁的患者 248 例。年轻组和老年组患者的无复发生存率、无进展生存率和癌症特异性生存率无显著差异。年轻组和老年组患者的无复发生存率分别为 55.4%和 52.9%,无进展生存率分别为 75.9%和 76.6%,癌症特异性生存率分别为 87.5%和 89.9%(均 p>0.05)。在年龄最大的亚组中,差异也无统计学意义。在回归分析和倾向评分匹配中,年龄与任何分析终点均无统计学关联。最后,年轻组和老年组在中重度并发症发生率方面无统计学差异(47.6% vs. 44.5%;p>0.05)。

结论

本研究表明,年龄的增加与 T1HG 非肌肉浸润性膀胱癌患者接受卡介苗免疫治疗的肿瘤学结果或卡介苗毒性无关。

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