输尿管移行细胞癌术后膀胱复发的危险因素分析

目的探讨输尿管移行细胞癌术后膀胱复发的危险因素。方法回顾分析两附属医院2000~2010年原发性输尿管癌病例,统计其临床及病理资料,通过多因素回归分析与膀胱复发相关的危险因素,用Kaplan-Meier法计算膀胱无复发生存率。结果随访104例输尿管移行细胞癌患者,中位随访时间46个月(13~89个月),39例患者出现膀胱复发。尿脱落细胞学(P=0.000)、肿瘤数量(P=0.006)、肿瘤分级(P=0.039)及合并膀胱肿瘤(P=0.014)是输尿管移行细胞癌术后膀胱复发的独立危险因素。危险因素越多的患者,膀胱无复发生存率越差。结论尿脱落细胞学、肿瘤数量、肿瘤分级及合并膀胱肿瘤与输尿管移行细胞癌术后膀胱复发密切相关。含有危险因素的病例可能需密切随访和积极治疗。

Risk factors of postoperative intravesical recurrence of transitional cell carcinoma of the ureter

Objective To define the clinicopathological risk factors of intravesical recurrence of primary transitional cell carcinoma of the ureter after surgical intervention.Methods Patients with primary carcinoma of the ureter treated between January 2000 and December 2010 were retrospectively analyzed.The intravesical recurrence-free survival rate was calculated using Kaplan-Meier method.Multivariate analysis was conducted with Cox’s regression.Results A total of 104 patients were enrolled,who were followed up for a median of 46 months(13-89 months).Thirty-nine of the patients showed postoperative intravesical recurrence.Urine exfoliative cytology(P=0.000),number of tumors(P=0.006),tumor grade(P=0.039) and co-existence of bladder tumor(P=0.014) were found to independently influence the postoperative intravesical recurrence.Patients with more risk factors had poorer intravesical recurrence-free survival.Conclusions Urine exfoliative cytology,number of tumors,tumor grade and co-existence of bladder tumor are independent risk factors for postoperative intravesical recurrence of primary transitional cell carcinoma of the ureter.Close follow-up and rigorous treatment are essential for patients with high risk factors.