T2N0M0期上尿路尿路上皮癌患者预后相关因素分析:单中心235例患者回顾性研究

发布时间：2018-03-14 13:00

本文选题：上尿路尿路上皮癌　切入点：生存分析　出处：《北京大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:分析T2N0M0上尿路尿路上皮癌(upper tract urothelial carcinoma,UTUC)患者长期生存情况以及预后相关因素。方法:回顾性分析2000年1月至2013年12月于北京大学第一医院行手术治疗的T2N0M0 UTUC患者的临床和随访资料,应用Kaplan-Meier法计算生存率,Log-rank方法进行单因素分析,对单因素分析中有统计学差异的变量采用Cox模型进行多因素生存分析。结果:共235例T2N0M0 UTUC患者纳入研究,中位随访时间53(3~142)个月。入组患者中男性95例(40.4%),女性140例(59.6%);患者平均年龄(66.73±10.49)岁,末次随访时共有74例(31.5%)患者因肿瘤死亡,96例(40.9%)患者出现膀胱复发,中位死亡时间及复发时间分别为35个月和19.5个月。患者的3年和5年肿瘤特异性生存率分别为89.1%和85.9%;3年和5年无复发生存率分别为85.5%和80.2%。多因素分析发现,年龄大于55岁(HR=3.138,95%CI:1.348~7.306,P=0.008)和肿瘤直径大于5 cm(HR=3.320,95%CI:1.882~5.857,P0.001)是T2N0M0 UTUC患者术后肿瘤特异性死亡的独立危险因素;肿瘤发生在输尿管(HR=1.757,95%CI:1.159~2.664,P=0.008)和肿瘤低分级(HR=1.760,95%CI:1.151~2.692,P=0.009)是T2N0M0膀胱复发的危险因素。结论:T2N0M0 UTUC患者肿瘤特异性生存预后较好,肿瘤复发率同非浸润性UTUC相当,但复发较早。肿瘤直径大于5 cm和年龄大于55岁是T2N0M0 UTUC肿瘤特异性死亡的独立危险因素;肿瘤发生在输尿管和肿瘤低分级是T2N0M0 UTUC膀胱复发的危险因素。
[Abstract]:Objective: to analyze the long-term survival and prognostic factors of patients with upper tract urothelial carcinoma of upper urinary tract epithelium (T2N0M0). Methods: from January 2000 to December 2013, the patients with T2N0M0 UTUC undergoing surgical treatment in the first Hospital of Peking University were analyzed retrospectively. Clinical and follow-up data, Kaplan-Meier method was used to calculate survival rate and Log-rank method was used to carry out univariate analysis. Cox model was used for multivariate survival analysis of variables with statistical difference in univariate analysis. Results: 235 patients with T2N0M0 UTUC were included in the study. The median follow-up time was 53 ~ (3 / 142) months. 95 males (40.4%) and 140 females (59.6%) had bladder recurrence, with an average age of 66.73 卤10.49 years (74 cases died of cancer 40.9% at the last follow-up). The median time of death and recurrence were 35 months and 19. 5 months, respectively. The 3 and 5 year tumor specific survival rates were 89.1% and 85.9, respectively, and the 3 and 5 year recurrence free survival rates were 85.5% and 80.2%, respectively. The independent risk factors of tumor specific death in patients with T _ 2N _ 0M _ 0 UTUC were as follows: I: 1.3487.306P0.008) and the diameter of tumor 3.320cm-95CI: 1.8825.857P0.001; The recurrence rate of T2N0M0 UTUC patients with T2N0M0 was better than that of non-invasive UTUC patients, and the recurrence rate of T2N0M0 UTUC patients was similar to that of non-invasive UTUC, and the recurrence rate of T2N0M0 UTUC patients was similar to that of non-invasive UTUC, and the tumor recurrence rate was similar to that of non-invasive UTUC, and the recurrence rate of T2N0M0 UTUC patients was similar to that of non-invasive UTUC patients with T2N0M0. Conclusion the tumor recurrence rate of T2N0M0 UTUC patients is similar to that of non-invasive UTUC patients, and the tumor recurrence rate is similar to that of non-invasive UTUC. But the recurrence was earlier. Tumor diameter > 5 cm and age > 55 years were the independent risk factors of T2N0M0 UTUC tumor-specific death, tumor occurrence in ureter and tumor low grade were the risk factors of T2N0M0 UTUC bladder recurrence.
【作者单位】：北京大学第一医院泌尿外科北京大学泌尿外科研究所国家泌尿男性生殖系肿瘤诊治中心;
【基金】：北京自然科学基金(7152146) 北京市科学技术委员会“首都临床特色应用研究“(151100004015173)项目资助~~
【分类号】：R737.1

【相似文献】