非肌肉浸润性膀胱癌长期生存的预后因素:来自现实生活实践的18年回顾性研究。

IF 0.8 Q4 SURGERY
Chirurgia Pub Date : 2025-08-01 DOI:10.21614/chirurgia.3154
Sever Chiujdea, Bogdan Petruţ, Orsolya Martha, Ariana-Lisa Chiujdea, Daniel Porav-Hodade, Anca Ioana Răchită, Anca Sin
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引用次数: 0

摘要

非肌肉浸润性膀胱癌(NMIBC)是常见且异质性的,需要适应风险的治疗策略。卡介苗仍然是中等和高风险形式的标准,但其有效性受到有限的获取、可变的耐受性、治疗耐药性和卫生保健系统中断的影响。材料和方法:本回顾性研究旨在确定影响生存的预后因素,并评估COVID-19大流行的影响。虽然由于缺乏记录变量,我们无法直接评估COVID- 19大流行的影响,但我们假设这可能是导致BCG治疗在我们的现实环境中影响有限的原因。在Tg泌尿外科诊所诊断的297例初始组中,总共选择了100例患者。从2006年到2008年,一直持续到2024年。预后分析包括临床变量,RecScore和ProgScore使用EORTC风险计算器计算。没有使用具体的截止值;得分作为连续变量进行分析。结果:年龄大于70岁和肿瘤多样性与死亡率增加显著相关。RecScore与复发风险显著相关(p=0.0464)。在单变量分析中,ProgScore与死亡率有边际相关性(p=0.0561),但在多变量模型中无显著相关性(p= 0.9159)。卡介苗治疗有边际保护作用,但对生存率没有显著影响。尽管由于缺乏记录变量,我们无法直接评估COVID-19大流行的影响,但我们假设它可能导致了这一现实生活队列中的治疗中断。结论:研究结果支持了个性化、基于风险的策略的需求,并强调了将真实世界数据整合到NMIBC管理中的重要性,特别是在系统性中断的背景下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic Factors of Long-Term Survival in Non-Muscle-Invasive Bladder Cancer: An 18-Year Retrospective Study from Real-Life Practice.

Introduction: Non-muscle-invasive bladder cancer (NMIBC) is common and heterogeneous, requiring risk-adapted therapeutic strategies. BCG remains standard for intermediate- and high-risk forms, but its effectiveness is influenced by limited access, variable tolerance, treatment resistance, and healthcare system disruptions. Material and Methods: This retrospective study aimed to identify prognostic factors for survival with an additional assessment of the influence of the COVID-19 pandemic. Although we could not directly evaluate the effect of COVID- 19 pandemic due to lack of recorded variables,we hypothesize it may have contributed to the limited impact of BCG therapy in our real-world setting. A total of 100 patients were selected from an initial group of 297 diagnosed in the Urology Clinic of Tg.Mures between 2006 - 2008, followed up until 2024. Prognostic analysis included clinical variables, RecScore and ProgScore were calculated using the EORTC risk calculator. No specific cut-offs were applied; the scores were analyzed as continuous variables. Results: Age over 70 and tumor multiplicity were significantly associated with increased mortality. RecScore was significantly correlated with the risk of relapse (p=0.0464). ProgScore showed a marginal association with mortality in univariate analysis (p=0.0561), but was not significant in multivariate models (p=0,9159). BCG therapy had a marginal protective effect, but did not significantly influence survival. Although we could not directly evaluate the effect of COVID-19 pandemic due to lack of recorded variables,we hypothesize that it may have contributed to treatment discontinuities in this real-life cohort. Conclusions: The results support the need for personalized, risk-based strategies and underline the importance of integrating real-world data into NMIBC management, especially in the context of systemic disruptions.

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来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
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