局部肌层浸润性膀胱癌预后影响因素分析

  目的  探讨影响局部肌层浸润性膀胱癌患者长期生存的预后因素。  方法  回顾性分析2002年1月至2011年6月新疆医科大学第一附属医院肿瘤中心收治的133例局部浸润性膀胱癌患者临床资料，选择年龄、合并症、肾积水、肿瘤大小、病灶数目、T分期、淋巴结转移、病理类型、肿瘤分级、治疗方式等10个对预后可能产生影响的因素，采用Kaplan-Meier法和Log-rank检验，对有意义的单因素进行Cox多因素分析。  结果  随访4~114个月，全组患者1、3、5年生存率分别为77%、64%、52%。单因素分析显示T分期、淋巴结及肾积水对预后的影响有统计学意义（P < 0.05）。Cox多因素分析显示影响局部肌层浸润性膀胱癌患者预后的因素分别为:T分期（RR=2.001，P=0.001）、淋巴结（RR=2.250，P=0.045）、肾积水（RR=1.954，P=0.047）。  结论  肿瘤T分期、淋巴结转移及肾积水是局部肌层浸润性膀胱癌患者的预后影响因素。 

Prognostic Factors of Patients with Local Muscle-invasive Bladder Cancer

  Objective  This study aims to investigate the prognostic factors affecting the survival of patients with local muscle-invasive bladder cancer.  Methods  The clinical and follow-up data of 133 patients with local muscle-invasive bladder cancer were retrospectively analyzed. Fourteen possible prognostic factors included gender, age, nationality, smoking habits, alcohol drinking habits, coexisting disease, hydronephrosis, tumor size, multifocality, T stage, lymph node staging, pathological type, histological grade, treatments via the Kaplan-Meier method, or the Log-rank test. Multivariate analysis was performed using the Cox proportional hazard model.  Results  The follow-up period ranged from 4 months to 114 months. The 1-, 3-, and 5-year survival rates were 77%, 64%, and 52%, respectively. Univariate analysis showed that the T stage, lymph node staging, and hydronephrosis were prognosis factors (P < 0.05). Multivariate analysis by the Cox proportional hazard model showed T stage (RR = 2.001, P = 0.001), lymph node staging (RR = 2.250, P = 0.045), and hydronephrosis (RR = 1.954, P = 0.047) as the prognostic factors (P < 0.05).  Conclusion  Hydronephrosis, T stage, and lymph node staging were prognostic factors of local muscle-invasive bladder cancer.