保留膀胱的综合治疗与根治性膀胱切除术对肌层浸润性膀胱癌疗效的比较

目的 比较保留膀胱的综合治疗与根治性膀胱切除术治疗肌层浸润性膀胱癌(T2N0M0)的疗效.方法 回顾性分析比较162例保留膀胱的综合治疗,即经尿道膀胱肿瘤切除术+髂内动脉灌注化疗+膀胱内灌注化疗(A组)与117例根治性膀胱切除术组(B组)的肌层浸润性膀胱癌(T2N0M0)患者经过治疗后的生存率及术后生活质量评分.结果 A组1年、3年、5年生存率分别为94.44%、79.62%、62.96%,B组1年、3年、5年生存率分别为94.87%、76.92%、64.10%,两组患者1年、3年和5年生存率比较,差异均无统计学意义(P﹥0.05).A组和B组生活质量总健康状况评分分别为(63.12±11.69)分、(35.68±8.47)分,A组健康状况优于B组,差异有统计学意义(P﹤0.05);两组的躯体功能、角色功能、情绪功能、认知功能、疲倦、恶心呕吐、疼痛、失眠及便秘评分比较,差异有统计学意义(P﹤0.05).结论 肌层浸润性膀胱癌(T2N0M0)的保留膀胱综合治疗与根治性膀胱切除术患者的生存率无差异,但保留膀胱的综合治疗组的术后生活质量优于根治性膀胱切除术组.

Comparison of the efficacy of comprehensive bladder preservation surgery with radical cystectomy for muscle invasive bladder cancer

Objective To compare the curative effect of comprehensive bladder preservation surgery with radical cys-tectomy for T2N0M0 stage muscle invasive bladder cancer. Method In patients with stage T2N0M0 muscle invasive bladder cancer, 162 cases of patients who underwent comprehensive bladder preservation surgery (that is, transurethral resection of bladder tumor+internal iliac artery infusion chemotherapy+intravesical instillation chemotherapy, group A) and 117 cases of patients who underwent radical cystectomy (group B) were retrospectively analyzed to compare their postopera-tive survival rates and life quality scores. Result 1-, 3-and 5-year survival rates of group A were 94.44%, 79.62%and 62.96%respectively, while those of group B were 94.87%, 76.92%and 64.10%respectively. Differences of 1-, 3-and 5-year survival rates between two groups did not reach statistical significance (P>0.05). The overall health status scores (a life quality index) of group A and group B were (63.12 ± 11.69) and (35.68 ± 8.47) respectively, with group A better than group B and the difference reached statistical significance (P<0.05). The differences in physical function, role function, emotional function, cognitive function, fatigue, nausea and vomiting, pain, insomnia and constipation between the two groups were statistically significant (P<0.05). Conclusion In patients with stage T2N0M0 muscle invasive bladder cancer, there is no significant difference in survival rates between comprehensive bladder preservation surgery and radical cystec-tomy, but postoperative survival rates of comprehensive bladder preservation surgery group are better than those of radi-cal resection group.