Páez Borda A, Martín Osés E, de la Cal López M, Llorente Abarca C, Berenguer Sánchez A
Servicio de Urología, Hospital Universitario de Getafe, Madrid, España.
Arch Esp Urol. 1997 Mar;50(2):121-6.
When the traditional prognostic factors (tumor grade, stage, size, number and cytological findings) are used as guidelines for intravesical therapy of superficial bladder tumors and the reported results are compared, it is not uncommon to find unexplainable differences. This study was conducted to determine the prognostic factors for tumor recurrence and progression before instituting any type of adjuvant therapy for superficial bladder tumors.
81 consecutive patients with primary superficial bladder cancer (stage Ta-T1, grade 1-3) were entered into a surveillance protocol and controlled for a mean period of 14 months (range 3-44). Patient individual features (sex and age) and tumor characteristics (grade, stage, size, number, cytological findings) were analyzed to determine the risk of tumor recurrence and/or progression.
Logistic regression analysis identified age as the only independent prognostic factor for recurrence, which was 6.37 fold (2-42) more frequent for subjects aged 65 years or older. Given the low progression rate (3 cases; 4.8%), a formal risk analysis could not be performed.
The factors used to predict recurrence (tumor grade, stage, size, number and cytological findings) were not found to be independent in the present series. Certain predictors of tumor aggressiveness-such as age-, which could modify tumor biology, were found to predispose to tumor recurrence.
当将传统预后因素（肿瘤分级、分期、大小、数量及细胞学检查结果）用作浅表性膀胱肿瘤膀胱内治疗的指导原则并比较报告结果时，发现无法解释的差异并不罕见。本研究旨在确定在对浅表性膀胱肿瘤进行任何类型的辅助治疗之前，肿瘤复发和进展的预后因素。
81例连续性原发性浅表性膀胱癌患者（Ta-T1期，1-3级）进入监测方案，平均随访14个月（范围3-44个月）。分析患者个体特征（性别和年龄）及肿瘤特征（分级、分期、大小、数量、细胞学检查结果）以确定肿瘤复发和/或进展的风险。
逻辑回归分析确定年龄是复发的唯一独立预后因素，65岁及以上患者的复发频率是其他患者的6.37倍（2-42倍）。鉴于进展率较低（3例；4.8%），无法进行正式的风险分析。
在本系列研究中，用于预测复发的因素（肿瘤分级、分期、大小、数量及细胞学检查结果）并非独立因素。发现某些肿瘤侵袭性预测因素，如年龄，可改变肿瘤生物学行为，易导致肿瘤复发。
