102例肌层浸润性膀胱移行细胞癌预后影响因素分析

目的 研究影响肌层浸润性膀胱移行细胞癌患者预后相关因素.方法 回顾性分析102例肌层浸润性膀胱移行细胞癌患者的临床病理以及完整随访资料,分析因素包括患者性别、年龄、合并慢性病、肾积水、肿瘤多灶性、瘤体大小、T分期、淋巴结是否转移、肿瘤组织分化程度和治疗方法 ,采用Kaplan-Meier法计算总生存率,采用Log-rank检验进行单因素分析,用Cox模型进行多因素分析.结果 随访期为4~119个月,全部患者1、3、5年总生存率分别为78.3%、65.2%、52.9%,中位生存期为62个月.单因素分析显示不同T分期、淋巴结是否转移、不同肿瘤组织分化程度及有无肾积水患者预后差异有统计学意义(P﹤0.05).Cox多因素分析显示,合并慢性病(RR=2.068,P=0.026)和肾积水(RR=3.218,P=0.002)是影响局部肌层浸润性移行细胞膀胱癌患者预后的独立因素.结论 T分期、淋巴结转移情况、肿瘤组织分化程度及肾积水是局部肌层浸润性膀胱移行细胞癌患者预后相关因素,而合并症及肾积水是预后的独立影响因素.

Analysis of prognostic in factors 102 cases of muscle-invasive transitional cell carcinoma of the urinary bladder

Objective To investigate the prognostic factors affecting the survival of patients with muscle-invasive transitional cell carcinoma of bladder (TCCB). Method The clinicopathological profile and complete follow-up data of 102 cases of TCCB were retrospectively analyzed. The possible prognostic variables were analyzed, including gender, age, chronic comorbidities, hydronephrosis, multifocality, tumor size, T stage, N stage, lymph node metastasis, tumor tis-sue differentiation and treatment modalities. Overall survival (OS) rates were calculated by Kaplan-Meier method and Log-Rank test was used in univariate analysis. A multivariate analysis was performed by the Cox proportional hazard model. Result The follow-up period varied from 4 to 119 months, the OS of all the patients at 1-, 3-, and 5-year were 78.3%, 65.2%and 52.9%, respectively, with a median survival time of 62 months. The univariate analysis showed that the T stage, lymph node metastasis, tumor differentiation, hydronephrosis were all correlated with patients'prognosis (P<0.05). In multivariate Cox proportional hazard model analysis, the chronic comorbidities (RR=2.068, P=0.026) and hydro-nephrosis (RR=3.218, P=0.002) were the independent prognostic factors for survival of the local muscle-invasive TCCB patients (P<0.05). Conclusion T stage, lymph node metastasis, tumor differentiation and hydronephrosis were prognos-tic factors in patients with local muscle-invasive TCCB, while the comorbidities and hydronephrosis were independent prognostic factors.