Pikul Maksym, Gordiichuk Prokip, Stakhovsky Eduard
Department of Plastic and Reconstructive Oncourology, National Cancer Institute of Ukraine.
Department of Oncology, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine.
Ann Med Surg (Lond). 2024 Aug 6;86(9):5137-5144. doi: 10.1097/MS9.0000000000002424. eCollection 2024 Sep.
This study aims to assess the effectiveness of urothelial cancer treatment in Ukraine, utilizing population-based data from the National Cancer Registry. The primary goal is to evaluate trends and approaches to therapy, with a focus on overall survival rates in patients with urothelial tumors.
A retrospective cross-sectional analysis was conducted based on the National Cancer Registry, involving 12 698 patients (2008-2020) with urothelial tumors of the upper urinary tract (UTUC) and bladder cancer (BC) who underwent surgical treatment. Demographic indicators, surgical interventions, complications, and survival rates were analyzed.
The average age for all patients was 70 years. The number of patients undergoing radical treatment was 1820 (15%) among BC and 573 (59%) among UTUC. The 30-day readmission rate was low for both, with a slightly higher preference for UTUC (2.3 vs. 4.6%). Whereas grade III or higher Cl-Dindo complications were seen in only 0.2% of cases. Notable findings include low frequency of neoadjuvant (7%) and adjuvant chemotherapy (28%) among patients with invasive urothelial carcinomas. Median eGFR for invasive UTUC before and after surgery was 63.2 and 51.4 ml/min, respectively (=0.00054). The directly opposite trend was seen in BC-61.2 and 68.7 ml/min, respectively (=0.0026).For BC, the overall survival rates by stages were: I-73%, II-49%, III-18%, and IV-11% (χ=1807.207; =0.000001). As for UTUC, the 5-year overall survival rates corresponded to the literature data, but there was a pronounced negative trend towards a decrease in this indicator after a 10-year period for all stages (χ=146.298; =0.000003).
The study emphasizes the importance of effective systemic treatments, adherence to treatment guidelines, and the need for multidisciplinary consultations among Ukrainian patients with urothelial cancer.
本研究旨在利用国家癌症登记处的人群数据评估乌克兰尿路上皮癌的治疗效果。主要目标是评估治疗趋势和方法，重点关注尿路上皮肿瘤患者的总生存率。
基于国家癌症登记处进行回顾性横断面分析，纳入12698例（2008 - 2020年）接受手术治疗的上尿路尿路上皮肿瘤（UTUC）和膀胱癌（BC）患者。分析人口统计学指标、手术干预、并发症和生存率。
所有患者的平均年龄为70岁。接受根治性治疗的患者数量在膀胱癌中为1820例（15%），在上尿路尿路上皮肿瘤中为573例（59%）。两者的30天再入院率都较低，上尿路尿路上皮肿瘤的再入院率略高（2.3%对4.6%）。而III级或更高的Cl - Dindo并发症仅在0.2%的病例中出现。显著发现包括浸润性尿路上皮癌患者中新辅助化疗（7%）和辅助化疗（28%）的频率较低。浸润性上尿路尿路上皮癌手术前后的中位eGFR分别为63.2和51.4 ml/min（P = 0.00054）。在膀胱癌中观察到相反的趋势——分别为61.2和68.7 ml/min（P = 0.0026）。对于膀胱癌，各阶段的总生存率为：I期 - 73%，II期 - 49%，III期 - 18%，IV期 - 11%（χ = 1807.207；P = 0.000001）。至于上尿路尿路上皮肿瘤，5年总生存率与文献数据相符，但在所有阶段，10年后该指标有明显下降的负趋势（χ = 146.298；P = 0.000003）。
该研究强调了有效全身治疗、遵循治疗指南的重要性，以及乌克兰尿路上皮癌患者多学科会诊的必要性。
