Rafla M, Ibrahim A S, Sherif M, Valleron A J
Unite de Recherches Biomathematiques et Biostatistiques, Inserm U 263 et Universite Paris, France.
Br J Cancer. 1987 Dec;56(6):830-3. doi: 10.1038/bjc.1987.299.
The aim of the present study was to evaluate the prognostic factors of bilharzial bladder cancer treated by radical cystectomy: good prognosis is defined as a survival of more than one year, free of local recurrence or metastasis. Two groups of 155 patients, one with a good prognosis (GPG) and the other with a bad prognosis (BPG), through the period 1977-1983 at the National Cancer Institute of Cairo were systematically analyzed for 13 variables evaluated at the commencement of the one year follow-up. Nine factors proved to be of high prognostic value: age, tumour stage, size, grade and location in the bladder, lymph node involvement, metastasis, renal insufficiency and type of urinary diversion. Four variables appeared not to have prognostic value viz: sex, type of tumour (multiplicity), histopathology, and presence of ova of schistosoma haematobium in the specimen. Using a discriminant analysis technique to take into account the inter-relationships between the factors, it was found that tumour grade was the most important prognostic factor followed, in order of importance, by tumour stage, renal insufficiency, size of the tumour and lymph node involvement. Moreover, a simplified score for prognosis was determined: X = 10 grade (1 to 3) +5 stage (1 to 4) +6 renal insufficiency (Y/N) +1 diameter of the tumour (cm) +4 lymph node involvement (Y/N). The larger the score, the poorer the prognosis.
良好预后定义为生存期超过一年，无局部复发或转移。对1977年至1983年期间开罗国家癌症研究所的两组155例患者进行了系统分析，一组预后良好（GPG），另一组预后不良（BPG），在一年随访开始时评估了13个变量。九个因素被证明具有较高的预后价值：年龄、肿瘤分期、大小、分级和在膀胱中的位置、淋巴结受累情况、转移、肾功能不全和尿流改道类型。四个变量似乎没有预后价值，即：性别、肿瘤类型（多发性）、组织病理学以及标本中埃及血吸虫卵的存在情况。使用判别分析技术考虑各因素之间的相互关系，发现肿瘤分级是最重要的预后因素，其次按重要性顺序依次为肿瘤分期、肾功能不全、肿瘤大小和淋巴结受累情况。此外，确定了一个简化的预后评分：X = 10×分级（1至3级）+5×分期（1至4期）+6×肾功能不全（是/否）+1×肿瘤直径（厘米）+4×淋巴结受累情况（是/否）。分数越高，预后越差。
