Oncological outcomes of organ-sparing cystectomy versus standard radical cystectomy in male patients diagnosed with bladder cancer.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Zeyu Han, Yaxiong Tang, Xianyanling Yi, Jin Li, Jianzhong Ai
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引用次数: 0

Abstract

Purpose: To compare the oncological outcomes between standard radical cystectomy (SRC) and organ-sparing cystectomy (OSC) in male patients diagnosed with bladder cancer.

Methods: Patients with stage Ta-T3 bladder cancer who underwent OSC or SRC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The association between preoperative factors and the implementation of OSC was analyzed using logistic regression. Propensity score matching (PSM) was employed to balance baseline characteristics between the two groups. Patients' overall survival (OS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Subgroup analyses based on the T stage were also conducted.

Results: A total of 7264 patients were included, with 96.8% (7033 patients) receiving SRC and 3.2% (231 patients) receiving OSC. Patients with higher T stages and high-grade tumors were less likely to undergo OSC. After PSM, OSC was associated with significantly worse OS and CSS than SRC. Subgroup analysis revealed that OSC did not lead to worse OS and CSS in non-muscle invasive bladder cancer and T2 stage patients, but it resulted in significantly worse outcomes in T3 stage patients.

Conclusion: Our study indicates that OSC is associated with poorer oncological outcomes compared to SRC, particularly in patients with advanced-stage tumors. These findings suggest the need for stringent selection criteria for OSC in bladder cancer patients. Given the negative impact on prognosis, stage T3 should potentially be considered a contraindication for OSC. Further evidence is required to confirm these assertions.

在确诊为膀胱癌的男性患者中,保全器官膀胱切除术与标准根治性膀胱切除术的肿瘤学效果对比。
目的:比较男性膀胱癌患者接受标准根治性膀胱切除术(SRC)和保器膀胱切除术(OSC)的肿瘤治疗效果:2004年至2015年期间,从监测、流行病学和最终结果(SEER)数据库中找到了接受OSC或SRC手术的Ta-T3期膀胱癌患者。采用逻辑回归分析了术前因素与实施OSC之间的关联。采用倾向评分匹配(PSM)来平衡两组患者的基线特征。患者的总生存期(OS)和癌症特异性生存期(CSS)采用 Kaplan-Meier 法进行估算。此外,还进行了基于T分期的亚组分析:共纳入 7264 例患者,其中 96.8%(7033 例)接受了 SRC 治疗,3.2%(231 例)接受了 OSC 治疗。T分期较高和肿瘤分级较高的患者接受卵巢癌手术的几率较低。PSM后,OSC的OS和CSS明显低于SRC。亚组分析显示,OSC不会导致非肌层浸润性膀胱癌和T2期患者的OS和CSS恶化,但会导致T3期患者的预后明显恶化:我们的研究表明,与SRC相比,OSC与较差的肿瘤预后相关,尤其是在晚期肿瘤患者中。这些研究结果表明,需要对膀胱癌患者进行严格的卵巢癌手术选择标准。考虑到对预后的负面影响,T3 期有可能被视为 OSC 的禁忌症。这些论断还需要进一步的证据来证实。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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