Int J Urol:新辅助化疗对机器人辅助根治性膀胱切除术后患者的生存和复发模式的影响

2022-01-08 AlexYang MedSci原创

分析了新辅助化疗对机器人辅助根治性膀胱切除术后肌层浸润性膀胱癌患者的生存和复发模式的影响。

膀胱癌是美国第六大最常见的恶性肿瘤,2019年有超过8万个新病例和1.7万个死亡病例。近四分之一的患者为肌层浸润性疾病(临床分期≥T2)。如果仅用RC和区域淋巴结清扫治疗,其中几乎一半的患者会出现疾病复发。一项III期随机临床试验SWOG-8710证明了NAC iMIBC的益处,其中MVAC能够改善OS

近期,来自美国的研究人员在《Int J Urol》上发表文章,分析了新辅助化疗对机器人辅助根治性膀胱切除术后肌层浸润性膀胱癌患者的生存和复发模式的影响

研究人员使用国际机器人膀胱切除术联盟数据库,确定了2002年至2019年间接受机器人辅助根治性膀胱切除术治疗的肌层浸润性膀胱癌患者。比较了接受新辅助化疗和不接受新辅助化疗患者的生存结果、反应率和复发模式。使用Kaplan-Meier分析估计了生存分布,并使用log-rank检验进行了比较。

研究共纳入了1370名肌层浸润性膀胱癌患者,其中353名(26%)接受了新辅助化疗。经过27个月的中位随访,接受新辅助化疗患者的3年总生存率(74% vs 57%; log-rank P<0.01)、3年癌症特异性生存率(83% vs 73%; log-rank P=0.03)和3年无复发生存率(64% vs 48%; log-rank P<0.01)均更高。在单变量分析中,新辅助化疗是更高的总生存率、癌症特异性生存率和无复发生存率的预测因素,但在多变量分析中不是。在机器人辅助根治性膀胱切除术中,新辅助化疗组的病理降级(46% vs 23%;P<0.01)、完全反应(24% vs 8%;P<0.01)和边缘阴性(95% vs 91%;P<0.01)更为常见。新辅助化疗接受者的远处复发率较低(15% vs 22%; P<0.01),但局部复发率相似(12% vs 13%; P=0.93)。

NAC与非NAC患者的OS和RFS的Kaplan–Meier评估

综上所述,机器人辅助根治性膀胱切除术前接受新辅助化疗的肌层浸润性膀胱癌患者中,其生存率、病理降级比例和切除边缘阴性比例较高,远处复发也较少

原始出处:

Dharmesh Gopalakrishnan , Ahmed S Elsayed , Ahmed A Hussein et al. Impact of neoadjuvant chemotherapy on survival and recurrence patterns after robot-assisted radical cystectomy for muscle-invasive bladder cancer: Results from the International Robotic Cystectomy Consortium. Int J Urol. Dec 2021

 

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GetPortalCommentsPageByObjectIdResponse(id=1586275, encodeId=5e7315862e58f, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Mon Jan 10 11:07:44 CST 2022, time=2022-01-10, status=1, ipAttribution=)]
    2022-01-13 Kurimi

    国际机器人膀胱切除术联盟数据库 how to access?

    0

  5. 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GetPortalCommentsPageByObjectIdResponse(id=1586275, encodeId=5e7315862e58f, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Mon Jan 10 11:07:44 CST 2022, time=2022-01-10, status=1, ipAttribution=)]
    2022-01-10 ms8000000945331327

    学习学习学习学习学习学习

    0

  6. 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GetPortalCommentsPageByObjectIdResponse(id=1586275, encodeId=5e7315862e58f, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62219, encryptionId=38f8622191b, topicName=根治)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=26d917348678, createdName=jeanqiuqiu, createdTime=Mon Jan 10 11:07:44 CST 2022, time=2022-01-10, status=1, ipAttribution=)]
    2022-01-10 xue8602
  7. 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    2022-01-10 jeanqiuqiu

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膀胱癌是指发生在膀胱黏膜上的恶性肿瘤。是泌尿系统最常见的恶性肿瘤,也是全身十大常见肿瘤之一。占我国泌尿生殖系肿瘤发病率的第一位,而在西方其发病率仅次于前列腺癌,居第2位。

J Urol:老年营养风险指数(GNRI)是否能够预测膀胱癌术后并发症?

评估了术前GNRI是否与根治性膀胱切除术(RC)后30天的并发症有关。

Prostate:预后营养指数预测RALP治疗后患者的生化复发

评价了预后营养指数(PNI)在预测机器人辅助腹腔镜前列腺根治术(RALP)患者生化复发(BCR)中的作用。