对于伴有病理性膀胱侵犯的结直肠癌患者，部分膀胱切除术作为一种手术选择：一项原始回顾性研究。
Partial cystectomy as a surgical option for colorectal cancer patients with pathological bladder invasion: an original retrospective study.
作者信息
Lan Bing, Luo Rui, Li Yang, Wang Shijie, Jiang Wei, Zhong Yun, Zhang Xuneng, Zheng Qingyang, He Zichuan, Ma Bo, Wang Hui, Yang Keli, Wang Huaiming
机构信息
Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
出版信息
Therap Adv Gastroenterol. 2025 Jan 3;18:17562848241308387. doi: 10.1177/17562848241308387. eCollection 2025.
BACKGROUND
Limited research exists on colorectal cancer (CRC) patients with bladder invasion, with survival outcomes post-cystectomy underexplored and a debate between partial and total cystectomy ongoing.
OBJECTIVE
The study aimed to evaluate the effect of pathological bladder invasion on the long-term tumour prognosis of patients with clinically diagnosed bladder invasion in CRC after cystectomy.
DESIGN
Retrospective, cohort study.
METHODS
Our study involving 105 CRC patients with bladder invasion who had partial or total cystectomy from 2012 to 2020 collected surgical and pathological data. Groups were divided by pathological bladder invasion presence and compared for 3-year overall survival (OS) and recurrence-free survival (RFS) rates. Multiphoton imaging assessed collagen features in some samples.
RESULTS
Pathological bladder invasion was confirmed in 50 patients (48%). Of 94 who had partial cystectomy, 41 were in the bladder invasion (+) group. The 3-year OS and RFS rates were 62.97% and 57.35% for the bladder invasion (+) group, and 77.16% and 58.68% for the bladder invasion (-) group, with no significant differences in recurrence rates between groups ( > 0.05). There are also no significant differences in 3-year local recurrence and intravesical recurrence rates between the two groups (18.62% vs 25.83%, 7.73% vs 11.82%, > 0.05). Distant metastasis was identified as an independent risk factor for OS and RFS by univariate and multivariate Cox regression analyses. Of the 24 samples that underwent multi-photon imaging, 142 collagen features extracted did not show statistical differences.
CONCLUSION
Pathological bladder invasion impacts CRC patients' post-cystectomy survival may be less than what clinical practice implies. Partial cystectomy in cases with pathological bladder invasion might offer similar survival rates to total cystectomy.
TRIAL REGISTRATION
ChiCTR2300077861.
背景
关于结直肠癌（CRC）侵犯膀胱患者的研究有限，膀胱切除术后的生存结果尚未得到充分探索，部分膀胱切除术和全膀胱切除术之间的争论仍在继续。
目的
本研究旨在评估病理膀胱侵犯对结直肠癌临床诊断膀胱侵犯患者膀胱切除术后长期肿瘤预后的影响。
设计
回顾性队列研究。
方法
我们的研究纳入了2012年至2020年期间105例行部分或全膀胱切除术的结直肠癌侵犯膀胱患者，收集手术和病理数据。根据病理膀胱侵犯情况分组，比较3年总生存率（OS）和无复发生存率（RFS）。对部分样本进行多光子成像评估胶原特征。
结果
50例患者（48%）证实存在病理膀胱侵犯。在94例行部分膀胱切除术的患者中，41例属于膀胱侵犯（+）组。膀胱侵犯（+）组的3年OS率和RFS率分别为62.97%和57.35%，膀胱侵犯（-）组分别为77.16%和58.68%，两组复发率无显著差异（P>0.05）。两组3年局部复发率和膀胱内复发率也无显著差异（18.62%对25.83%，7.73%对11.82%，P>0.05）。单因素和多因素Cox回归分析确定远处转移是OS和RFS的独立危险因素。在接受多光子成像的24个样本中，提取的142个胶原特征无统计学差异。
结论
病理膀胱侵犯对结直肠癌患者膀胱切除术后生存的影响可能小于临床实践所暗示的。病理膀胱侵犯病例行部分膀胱切除术可能与全膀胱切除术生存率相似。
试验注册号
ChiCTR2300077861。
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