Nechifor-Boilă Ioan Alin, Chibelean Bogdan Călin, Loghin Andrada, Nechifor-Boilă Adela Corina, Voidăzan Toader Septimiu, Rădulescu Maria Flavia, Borda Angela
Department of Urology, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania;
Rom J Morphol Embryol. 2019;60(4):1183-1190.
Urothelial carcinoma (UC) variants are considered as having a more aggressive behavior and a more advanced stage at presentation than conventional UC. However, the evidence supporting the role of UC variants on overall survival (OS) is conflicting. We aimed to assess the impact of demographic factors (age at surgery, gender) and tumor characteristics [conventional∕variant UC, associated carcinoma in situ (CIS), associated papillary component, Tumor, Node, Metastasis (TNM) staging, positive surgical margins] on OS in a series of patients treated for UC in our Department.
PATIENTS, MATERIALS AND METHODS: We performed a retrospective, cohort study and included 69 UC patients treated by radical cystectomy (RC) in our Department over an eight-year period, with complete follow-up information. Associations of UC variants as well as demographic and morphological factors with OS were assessed using univariable and multivariable Cox analysis.
Our data showed that UC variants were statistically significantly associated with the presence of distant metastases (p=0.036) and positive surgical margins (p=0.009), but had no influence on OS (p=0.504). Further on, we demonstrated that age at surgery (p=0.045), tumor stage (p=0.012), lymph node involvement (p=0.009), and presence of positive surgical margins (p=0.002) had a statistically significant influence on OS both by univariable and multivariable Cox analysis.
Age, tumor stage and lymph node involvement, as well as positive surgical margins represent prognostic factors in RC patients. UC variants were more likely to be associated to metastases and positive surgical margins but had no influence on OS.
与传统尿路上皮癌（UC）相比，UC变异型被认为具有更侵袭性的行为，且在初诊时分期更晚。然而，支持UC变异型对总生存期（OS）影响的证据存在矛盾。我们旨在评估人口统计学因素（手术年龄、性别）和肿瘤特征[传统/变异型UC、伴发原位癌（CIS）、伴发乳头状成分、肿瘤-淋巴结-转移（TNM）分期、手术切缘阳性]对我科接受UC治疗的一系列患者OS的影响。
患者、材料与方法：我们进行了一项回顾性队列研究，纳入了我科在八年期间接受根治性膀胱切除术（RC）治疗的69例UC患者，并获得了完整的随访信息。使用单变量和多变量Cox分析评估UC变异型以及人口统计学和形态学因素与OS的相关性。
我们的数据显示，UC变异型与远处转移的存在（p = 0.036）和手术切缘阳性（p = 0.009）在统计学上显著相关，但对OS没有影响（p = 0.504）。此外，我们证明，通过单变量和多变量Cox分析，手术年龄（p = 0.045）、肿瘤分期（p = 0.012）、淋巴结受累（p = 0.009）和手术切缘阳性的存在（p = 0.002）对OS均有统计学显著影响。
年龄、肿瘤分期和淋巴结受累以及手术切缘阳性是RC患者的预后因素。UC变异型更可能与转移和手术切缘阳性相关，但对OS没有影响。
