Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, 100730, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
BMC Cancer. 2020 Sep 4;20(1):851. doi: 10.1186/s12885-020-07354-7.
The risk of positive lymph nodes in patients with muscle-invasive bladder urothelial carcinoma (MIBC) can be used to guide treatment recommendations. However, little is known about the effect of age on lymph node positivity (LN+). This study aimed to evaluate the effect of age on LN+ in MIBC.
We analyzed patients with stage T2-T4 bladder urothelial carcinoma who had not received preoperative radiotherapy, had at least one lymph node examined, and underwent cystectomy between 1998 and 2015. The Cochran-Armitage trend test and logistic univariate and multivariate analyses were used to evaluate the effect of age on LN+ in all T stages.
In total, 15,624 patients with MIBC were identified, including 747 patients aged ≤50 years (4.78%), 2614 patients aged 50-59 years (16.73%), 4914 patients aged 60-69 years (31.45%), 5225 patients aged 70-79 years old (33.44%), and 2124 patients aged > 80 years (13.59%). In T2-T4 staging, LN+ was negatively correlated with age. After adjustment for several covariates, multivariate logistic regression analysis revealed that age was an independent risk factor for LN+.
In this large SEER analysis, Young patients with MIBC have a higher risk of lymph node metastasis. This finding is worthy of further study and may eventually affect the treatment decisions of young patients.
肌层浸润性膀胱癌（MIBC）患者的阳性淋巴结风险可用于指导治疗建议。然而，对于年龄对淋巴结阳性（LN+）的影响知之甚少。本研究旨在评估年龄对 MIBC 中 LN+的影响。
我们分析了 1998 年至 2015 年间未接受术前放疗、至少有一个淋巴结被检查、并接受了膀胱根治性切除术的 T2-T4 期膀胱尿路上皮癌患者。采用 Cochran-Armitage 趋势检验和逻辑单因素及多因素分析来评估所有 T 分期中年龄对 LN+的影响。
共纳入 15624 例 MIBC 患者，包括≤50 岁 747 例（4.78%）、50-59 岁 2614 例（16.73%）、60-69 岁 4914 例（31.45%）、70-79 岁 5225 例（33.44%）和>80 岁 2124 例（13.59%）。在 T2-T4 分期中，LN+与年龄呈负相关。经过多个协变量调整后，多因素逻辑回归分析显示，年龄是 LN+的独立危险因素。
在这项大型 SEER 分析中，年轻的 MIBC 患者有更高的淋巴结转移风险。这一发现值得进一步研究，可能最终会影响年轻患者的治疗决策。
