摘要
目的 :分析膀胱癌的各种临床和病理因素与患者预后的关系 ,探讨影响膀胱癌患者长期生存的参数。方法 :采用寿命表、时序检验分析等统计学方法 ,分析我科 1952～ 1995年间收治并随访 6个月～ 2 5年的 355例膀胱癌患者总体生存率、病理分期与分级、肿瘤类型以及手术方法与患者预后的关系。结果 :355例中 ,最终生存 2 36例 ,死于膀胱癌 90例 ,死于其他疾病 2 9例。总体 5年和 10年生存率分别为 77.8%和 67.4 %。各期膀胱癌患者 5年生存率分别为 Ta～ T1期 91.9% ,T2期 84 .3% ,T3期 4 3.9% ,T4 期 10 .2 % ( P <0 .0 1)。各级膀胱癌患者 5年生存率分别为 G1级91.4 % ,G2 级 82 .7% ,G3级 62 .6% ( P <0 .0 1)。移行细胞癌、腺癌和鳞癌的 5年生存率分别为79.8%、58.3%和 2 2 .9% ( P <0 .0 1)。各种手术患者 5年生存率分别为 TUR10 0 .0 % ,膀胱部分切除术 81.8% ,全膀胱切除术 63.1% ( P <0 .0 5)。结论 :虽然膀胱癌的分级、类型和手术方法均与肿瘤的预后密切相关 ,但膀胱癌的浸润程度仍然是预测膀胱癌预后最重要的单因素。
Purpose: To study the parameters influencing the long-term surviving of patients with the bladder cancer. Methods: 355 cases of bladder cancer, treated from 1952 to 1995 and followed up for 6 months ~ 25 years, were studied retrospectively. The analysis of the overall survival rate, the survival rates according to stage, grade, cell type of the bladder cancer and primary operative procedures were carried out by the life table method and log rank test statistically. Results: 236 cases of the patients still lived at the end of follow up, 90 cases died of the bladder cancer and 29 died of other causes. The overall 5 year and 10 year survival rates were 77.8% and 67.4% respectively. The 5 year survival rate according to the stage was 91.9 % of Ta～T 1 tumors, 84.3 % of T 2, 43.9 % of T 3, 10.2 % of T 4, respectively with significant difference statistically (P< 0.001 ). The grade of the tumors also showed the prognostic meaning with the 5 year survival rate of 91.4 % of G 1, 82.7 % of G 2, 62.6 % of G 3 (P<0.01). Transitional cell carcinoma was the best of three types of bladder cancer with 5 year survival rate of 79.8 %, followed by adenocarcinoma 58.3 % and squamous carcinoma 22.9 % (P< 0.01 ). The 5 year survival rates of different operation groups were TUR 100.0 %, partial cystectomy 81.8% and total cystectomy 63.1 %(P< 0.05 ). Conclusions: The stage of bladder cancer is the most important parameter predicting the prognosis of the cancer, although the grade, cell type of the tumor and operative methods are also correlated with the of outcome of the patients.
出处
《临床泌尿外科杂志》
1999年第6期256-259,共4页
Journal of Clinical Urology
