膀胱部分切除术和根治性切除术治疗肌层浸润性膀胱癌的回顾性分析

发布时间：2018-05-16 11:06

本文选题：膀胱部分切除术 + 根治性膀胱切除术　；参考：《济南大学》2017年硕士论文

【摘要】：目的比较膀胱部分切除术和根治性膀胱切除术治疗肌层浸润性膀胱癌的临床疗效,探讨膀胱部分切除术在肌层浸润性膀胱尿路上皮癌中的应用价值。方法回顾性分析2002年1月-2012年1月山东大学附属山东省肿瘤医院泌尿外科收治的126例肌层浸润性膀胱癌(T2-T3)患者的临床资料,根据手术方式的不同,分为膀胱部分切除术组(A组)和根治性膀胱切除组(B组),统计分析两组患者住院时间、手术时间、术中出血量、1年生存率、3年生存率、5年生存率、患者术后生活质量,及T2、T3期膀胱癌患者部分切除与根治性切除术后1年生存率、3年生存率、5年生存率,以评价膀胱部分切除术在肌层浸润性膀胱癌中的治疗效果。结果共入组126例,其中A组62例,其中男性55例,女性7例,低级别尿路上皮癌13例,高级别尿路上皮癌49例,年龄在38-75岁之间;B组64例,其中男性51例,女性13例,其中低级别尿路上皮癌14例,高级别尿路上皮癌50例,年龄在36-75岁之间。A组患者术后1年、3年、5年生存率分别是90.32%,67.74%,46.77%,B组患者术后1年、3年、5年生存率分别是89.06%,82.81%,65.63%;两者术后3、5年生存率差异有统计学意义(根治手术组优于部分切除术)。T2期患者行膀胱部分切除术后1年、3年、5年生存率分别是87.50%,81.25%,62.50%,行膀胱根治性切除术后1年、3年、5年生存率分别是91.67%,87.50%,70.83%,两者之间差异均无统计学意义,但膀胱部分切除术手术时间短、出血量少、住院时间短,并且患者生活质量明显优于根治术者。T3期患者行膀胱部分切除术联合术后化疗术后1年、3年、5年生存率分别是93.33%,53.33%,30.00%,行膀胱根治性切除术后1年、3年、5年生存率分别是87.50%,80.00%,62.50%,两者术后3、5年生存率差异有统计学意义。结论1.对于T2期膀胱癌患者,膀胱部分切除术1、3、5年生存率与根治术无差异,但其手术时间短、出血量少、住院时间短,并且患者生活质量明显优于根治术,膀胱部分切除术是可选择的术式;2.对于T3膀胱癌,根治性手术3年、5年生存率高于膀胱部分切除术。
[Abstract]:Objective to compare the clinical efficacy of partial cystectomy and radical cystectomy in the treatment of myometrial invasive bladder cancer and to explore the value of partial cystectomy in the treatment of myometrial invasive bladder urothelial carcinoma. Methods the clinical data of 126 patients with intramuscular invasive bladder cancer (T2-T3) treated in Department of Urology, Shandong Cancer Hospital affiliated to Shandong University from January 2002 to January 2012 were retrospectively analyzed. Two groups were divided into two groups: partial cystectomy group (group A) and radical cystectomy group (group B). The hospitalization time, operation time, intraoperative bleeding volume, 1 year survival rate, 3 year survival rate, 5 year survival rate and postoperative quality of life were statistically analyzed. In order to evaluate the therapeutic effect of partial cystectomy on invasive bladder cancer, 1 year survival rate, 3 year survival rate and 5 year survival rate after partial resection and radical resection were evaluated. Results there were 126 cases in group A, including 55 males, 7 females, 13 cases of low grade urothelial carcinoma, 49 cases of high grade urothelial carcinoma, 64 cases of group B aged between 38 and 75 years, including 51 males and 13 females. Among them, there were 14 cases of low grade urothelial carcinoma and 50 cases of high grade urothelial carcinoma. The 1-year, 3-year and 5-year survival rates of patients in group A aged between 36 and 75 years were 90.32 and 67.74and 46.77 respectively. The survival rates of group B were 82.81% and 65.63%, respectively, and the survival rates of group B were significantly higher than those of group B (radical operation group was better than group B). The 1 year, 3 year and 5 year survival rates of partial cystectomy were 87.50% and 81.25% respectively after partial cystectomy. The survival rates of 1 year, 3 year and 5 year after radical cystectomy were 91.67%, 87.50% and 70.83%, respectively. There was no significant difference between the two groups. However, partial cystectomy had shorter operative time, less bleeding, and shorter hospital stay. And the quality of life of the patients with stage T3 was significantly better than that of the patients undergoing partial cystectomy combined with postoperative chemotherapy. The survival rates for 1 year, 3 years and 5 years after radical cystectomy were 93.33 and 53.33 respectively. The survival rates of 1, 3 and 5 years after radical cystectomy were respectively 1, 3 and 5 years, respectively. The 3- and 5-year survival rates were significantly different between the two groups. Conclusion 1. For patients with stage T2 bladder cancer, there was no difference in the survival rate of 1 and 5 years between partial cystectomy and radical resection, but the operation time was short, the amount of bleeding was less, the hospitalization time was short, and the quality of life of the patients was obviously better than that of radical surgery. Partial cystectomy is an optional procedure. For T 3 bladder cancer, the 5-year survival rate of radical surgery was higher than that of partial cystectomy.
【学位授予单位】：济南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.14

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