摘要
目的探究行经尿道膀胱肿瘤切除术(TURBT)的中低风险非肌层浸润性膀胱癌(NMIBC)患者单次即刻膀胱灌注化疗(SIIC)后膀胱持续生理盐水冲洗(CSBI)的治疗效果。方法回顾性分析2004年1月—2019年12月于北京大学人民医院泌尿外科行TURBT的211例中低风险NMIBC患者的临床资料,根据患者SIIC后是否进行CSBI分为CSBI组和无CSBI组,比较两组患者的复发率、进展率、无复发生存率和无进展生存率。通过Cox单因素及多因素回归分析探究CSBI是否为患者肿瘤复发和进展的危险因素。结果两组患者的基线资料、复发率和进展率比较,差异均无统计学意义(P>0.05)。两组患者无复发生存率比较无明显差异,而CSBI组无进展生存率更低(χ^(2)=8.270,P=0.004)。在多因素Cox回归分析中,糖尿病(HR:2.240,95%CI:1.066~4.704,P=0.033)和多发肿瘤(HR:3.060,95%CI:1.639~5.711,P<0.001)是中低风险NMIBC患者肿瘤复发的独立危险因素,CSBI(HR:7.914,95%CI:1.710~36.632,P=0.008)是肿瘤进展的独立危险因素。结论SIIC后CSBI可能会增加中低风险NMIBC患者的进展风险,但该结论仍需要更大样本量进行验证。
Objective To investigate the efficacy of continuous saline bladder irrigation(CSBI)after a single immediate instillation of chemotherapy(SIIC)in patients with low-and immediate-risk non-muscle-invasive bladder cancer(NMIBC)undergoing transurethral resection of bladder tumor(TURBT).Methods Clinical data of 211 patients with with low-and immediate-risk NMIBC,who underwent TURBT in our hospital during Jan.2004 and Dec.2019 were collected.The patients were divided into two groups according to whether CSBI was conducted after SIIC.The recurrence rate,progression rate,recurrence-free survival and progression-free survival of the two groups were compared.Cox univariate and multivariate regression analyses were used to investigate whether CSBI was a risk factor for recurrence and progression.Results There were no significant differences in baseline data,recurrence rate and progression rate between the two groups(P>0.05).There was no significant difference in recurrence-free survival between the two groups,but the progression-free survival was shorter in CSBI group(χ^(2)=8.270,P=0.004).Multivariate Cox regression analysis indicated that diabetes(HR:2.240,95%CI:1.066-4.704,P=0.033)and multiple tumors(HR:3.060,95%CI:1.639-5.711,P<0.001)were independent risk factors for recurrence and CSBI(HR:7.914,95%CI:1.710-36.632,P=0.008)was an independent risk factor for progression.Conclusion CSBI after SIIC may increase the risk of progression in patients with low-and immediate-risk NMIBC,but a larger sample size is needed for validation.
作者
王飞
杜依青
秦彩朋
李清
刘士军
徐涛
WANG Fei;DU Yiqing;QIN Caipeng;LI Qing;LIU Shijun;XU Tao(Department of Urology,Peking University People's Hospital,Beijing 100044,China)
出处
《现代泌尿外科杂志》
CAS
2024年第6期481-485,共5页
Journal of Modern Urology
基金
国家重点研发计划项目(No.2018YFA0902802)
国家自然科学基金项目(No.82271877)
北京市科学技术委员会项目(No.Z221100007422058)
北京大学人民医院研究与发展基金资助课题项目(No.RDGS2022-02)。
关键词
膀胱癌
单次即刻膀胱灌注化疗
膀胱持续生理盐水冲洗
膀胱内复发
肿瘤进展
bladder cancer
single immediate instillation of chemotherapy
continuous saline bladder irrigation
intravesical recurrence
tumor progression
