Zhu Jun, Ye Xin, Zhou Liqun, He Zhisong, Jin Jie, Yu Wei
Department of Urology, Peking University First Hospital, Beijing, China.
Institute of Urology, Peking University, National Urological Cancer Center, Beijing, China.
Transl Cancer Res. 2022 Oct;11(10):3584-3592. doi: 10.21037/tcr-22-944.
To compare the survival outcomes of patients over 85 years of age with bladder cancer.
We used data collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier (KM) curves were generated for overall survival with 95% confidence intervals (CIs). Cox proportional hazard models were used to estimate the hazard ratios among cases in different groups.
Of the 9,321 patients who met the inclusion criteria, 6,703 (71.9%) were men and 2,618 (28.1%) were women, with a mean (standard deviation) age of 88.68 (3.216) years. The median follow-up time of this cohort was 18 months. In the low-grade non-muscle-invasive bladder cancer (LG NMIBC) group, our analysis showed that no further treatment led to a better prognosis after the first transurethral bladder tumor resection (TURBT). In the high-grade NMIBC (HG NMIBC) cohort, major therapy was correlated with better OS in univariable and multivariable analyses [hazard ratio (HR) 0.450; 95% CI: 0.351-0.577]. Trimodal therapy gave a better prognosis in the muscle-invasive bladder cancer (MIBC) cohort (HR 1.395; 95% CI: 1.147-1.697). In addition, none of the county factors were risk factors for prognosis in multivariable analysis.
Minor and major therapies do not have a better prognosis after TURBT in LG NMIBC. Major therapy has better oncological outcomes in LG NMIBC and MIBC than minor therapy. Trimodal therapy leads to longer OS in MIBC. In addition, none of the county factors were risk factors for prognosis.
比较85岁以上膀胱癌患者的生存结局。
我们使用了从监测、流行病学和最终结果（SEER）数据库收集的数据。生成了总生存的Kaplan-Meier（KM）曲线及95%置信区间（CI）。采用Cox比例风险模型估计不同组病例之间的风险比。
在符合纳入标准的9321例患者中，6703例（71.9%）为男性，2618例（28.1%）为女性，平均（标准差）年龄为88.68（3.216）岁。该队列的中位随访时间为18个月。在低级别非肌层浸润性膀胱癌（LG NMIBC）组中，我们的分析显示，首次经尿道膀胱肿瘤切除术（TURBT）后不再进行进一步治疗可带来更好的预后。在高级别NMIBC（HG NMIBC）队列中，单变量和多变量分析显示主要治疗与更好的总生存相关[风险比（HR）0.450；95%CI：0.351-0.577]。三联疗法在肌层浸润性膀胱癌（MIBC）队列中预后更好（HR 1.395；95%CI：1.147-1.697）。此外，在多变量分析中，没有一个县级因素是预后的危险因素。
LG NMIBC患者TURBT后，次要和主要治疗均未带来更好的预后。在LG NMIBC和MIBC中，主要治疗比次要治疗具有更好的肿瘤学结局。三联疗法可使MIBC患者的总生存时间更长。此外，没有一个县级因素是预后的危险因素。
