Department of Urology, Bozyaka Training and Research Hospital, Izmir, Turkey.
Int Braz J Urol. 2020 Jul-Aug;46(4):566-574. doi: 10.1590/S1677-5538.IBJU.2019.0205.
To evaluate the influence of preoperative renal function on survival outcomes in patients who underwent radical cystectomy (RC) with non-continent urinary diversion (UD).
A total of 132 patients with bladder cancer who underwent RC with non-continent UD due to urothelial carcinoma from January 2006 toMarch 2017 at our tertiary referral center were retrospectively evaluated. Patients were divided into 2 groups as those with estimated glomerular filtration rate (eGFR)<60mL/min/1.73 m2 and ≥60mL/min/1.73 m2 according to preoperative eGFR levels. Patients' characteristics, preoperative clinical data, operative data, pathologic data, oncologic data and complications were compared between the groups.
The mean age was 64.5±8.7 (range: 32 - 83) years and the median follow-up was 30.9±31.7 (range: 1-113) months. There were 46 patients in Group 1 and 86 patients in Group 2. There was no difference in cancer-specific mortality (45.6% for group 1 and 30.2% for group 2, p=0.078) and survival (56.8±8.3 months for group 1 and 70.5±5.9 months for group 2, p=0.087) between the groups. Overall mortality was higher (63% for group 1 and 40.7% for group 2, p=0.014) and overall survival (43.6±6.9 months for group 1 and 62.2±5.8 months for group 2, p=0.03) was lower in Group 1 compared to Group 2.
Overall mortality was higher and overall survival was lower in patients with preoperative eGFR<60mL/s. More patients had preoperative hydronephrosis with eGFR<60mL/s.
评估行根治性膀胱切除术(RC)+非可控性尿流改道术(UD)的患者术前肾功能对生存结局的影响。
回顾性分析 2006 年 1 月至 2017 年 3 月期间,在我院接受 RC+非可控性 UD 的 132 例膀胱癌患者的资料,所有患者均为尿路上皮癌。根据术前估算肾小球滤过率(eGFR)水平将患者分为 eGFR<60mL/min/1.73m2 组和≥60mL/min/1.73m2 组。比较两组患者的特征、术前临床资料、手术资料、病理资料、肿瘤学资料和并发症。
患者的平均年龄为 64.5±8.7(范围:32-83)岁,中位随访时间为 30.9±31.7(范围:1-113)个月。其中,1 组有 46 例,2 组有 86 例。两组间在癌症特异性死亡率(1 组为 45.6%,2 组为 30.2%,p=0.078)和生存(1 组为 56.8±8.3 个月,2 组为 70.5±5.9 个月,p=0.087)方面无差异。1 组的总死亡率(63%)高于 2 组(40.7%,p=0.014),总生存(1 组为 43.6±6.9 个月,2 组为 62.2±5.8 个月,p=0.03)低于 2 组。
术前 eGFR<60mL/s 的患者总死亡率更高,总生存更差。eGFR<60mL/s 的患者术前更易发生肾积水。