World J Urol:根治性膀胱切除术pentafecta的多中心外部验证

2021-07-24 AlexYang MedSci原创

每年全世界有270万人诊断为膀胱癌或因膀胱癌(BCa)而治疗。对于没有转移证据的局部晚期肌层浸润性膀胱癌(MIBC),新辅助铂类全身治疗和根治性膀胱切除术(RC)以及广泛的双侧盆腔淋巴结清扫术(PLN

每年全世界有270万人诊断为膀胱癌或因膀胱癌(BCa)而治疗。对于没有转移证据的局部晚期肌层浸润性膀胱癌(MIBC),新辅助铂类全身治疗和根治性膀胱切除术(RC)以及广泛的双侧盆腔淋巴结清扫术(PLND)是推荐的一线治愈性治疗。然而,这种手术在技术上要求很高,并发症约为25%,死亡率为1-2%,且而不考虑手术方法。包括机器人辅助在内技术的开发减少了围手术期和死亡率。

近期,有研究人员对RC-pentafecta进行了外部验证

在2014年1月至2019年12月期间,研究人员对6个泌尿外科中心内接受RARC与ICUD的104名连续患者进行了回顾性分析。同时表现出软组织手术边缘(STSMs)阴性、淋巴结(LN)产量≥16、无重大(Clavien-Dindo III-V级)术后90天并发症、无UD相关长期后遗症、无12个月临床复发的患者认为达到了RC-pentafecta。多变量逻辑回归模型用来衡量达到RC-pentafecta的预测因素。研究人员还分析了RC-pentafecta对生存的影响以及对手术经验的影响。

自2014年以来,研究共纳入了104名完成了至少12个月随访的患者。在平均18个月的随访中,分别有56%、96%、85%、81%和91%的患者观察到LN产量≥16,STSMs阴性,90天内无主要并发症,以及≤12个月内无UD相关手术后遗症和临床复发,因此RC-pentafecta比例为39.4%。多变量分析显示,年龄是实现pentafecta的独立预测因素(几率[OR],0.96;95%置信区间[CI],0.90. 0.99;P=0.04)。外科医生的经验对标准的验证有影响。

RC-pentafecta标准的百分比

综上所述,RC-pentafecta是可重复的,可以从外部用于RARC与ICUD后的结果评估。因此,RC-pentafecta可以成为评估手术成功及其对不同结果影响的有用工具

原始出处:

P Baron, Z Khene, F Lannes et al. Multicenter external validation of the radical cystectomy pentafecta in a European cohort of patients undergoing robot-assisted radical cystectomy with intracorporeal urinary diversion for bladder cancer. World J Urol. Jul 2021

 

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    2021-09-17 feather89
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objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85774, encryptionId=238d85e749c, topicName=膀胱切除术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e77d9117128, createdName=tonychen24, createdTime=Mon Jul 26 02:46:01 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1586244, encodeId=df461586244c1, content=<a href='/topic/show?id=38f8622191b' target=_blank style='color:#2F92EE;'>#根治#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, 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 Jul 26 02:46:01 CST 2021, time=2021-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002362, encodeId=49c2100236205, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:23:16 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002357, encodeId=cb04100235e08, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:22:43 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002326, encodeId=ea0310023262a, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:01:25 CST 2021, time=2021-07-24, status=1, ipAttribution=)]
    2021-11-06 windight
  5. 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GetPortalCommentsPageByObjectIdResponse(id=1002326, encodeId=ea0310023262a, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:01:25 CST 2021, time=2021-07-24, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1973302, encodeId=130e19e330286, content=<a href='/topic/show?id=75a16223199' target=_blank style='color:#2F92EE;'>#根治性膀胱切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62231, encryptionId=75a16223199, topicName=根治性膀胱切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f6142500060, createdName=12498710m11暂无昵称, createdTime=Wed Sep 08 06:46:01 CST 2021, time=2021-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1904077, encodeId=7ad419040e759, content=<a href='/topic/show?id=7d454302945' target=_blank style='color:#2F92EE;'>#多中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43029, encryptionId=7d454302945, topicName=多中心)], attachment=null, authenticateStatus=null, createdAvatar=, 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  7. 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GetPortalCommentsPageByObjectIdResponse(id=1002326, encodeId=ea0310023262a, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:01:25 CST 2021, time=2021-07-24, status=1, ipAttribution=)]
    2021-07-26 jeanqiuqiu
  8. [GetPortalCommentsPageByObjectIdResponse(id=1973302, encodeId=130e19e330286, content=<a href='/topic/show?id=75a16223199' target=_blank style='color:#2F92EE;'>#根治性膀胱切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=62231, encryptionId=75a16223199, topicName=根治性膀胱切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f6142500060, createdName=12498710m11暂无昵称, createdTime=Wed Sep 08 06:46:01 CST 2021, time=2021-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1904077, encodeId=7ad419040e759, content=<a href='/topic/show?id=7d454302945' target=_blank style='color:#2F92EE;'>#多中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43029, encryptionId=7d454302945, topicName=多中心)], attachment=null, authenticateStatus=null, createdAvatar=, 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    2021-07-24 @gxl

    非常受用

    0

  9. 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    2021-07-24 @gxl

    非常受用

    0

  10. 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encodeId=49c2100236205, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:23:16 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002357, encodeId=cb04100235e08, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:22:43 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002326, encodeId=ea0310023262a, content=非常受用, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210724/725901dc0ed249ebba9d096aacddde3f/a89b874e17434adb82b0c2dff5f374f1.jpg, createdBy=c0225555986, createdName=@gxl, createdTime=Sat Jul 24 19:01:25 CST 2021, time=2021-07-24, status=1, ipAttribution=)]
    2021-07-24 @gxl

    非常受用

    0

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