淋巴血管侵袭和组织学变异对bcg治疗的高级别NMIBC预后的影响。

IF 1.2 4区 医学 Q4 ONCOLOGY
Bladder Cancer Pub Date : 2025-09-11 eCollection Date: 2025-07-01 DOI:10.1177/23523735251370645
Ali Nebioğlu, Mert Başaranoğlu, Murat Bozlu, Yasemin Yuyucu Karabulut
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引用次数: 0

摘要

目的:本研究旨在评估淋巴血管侵袭(LVI)和组织学亚型对高度非肌肉浸润性膀胱癌(NMIBC)卡介苗治疗后预后的影响。方法:我们回顾性分析了2010年1月至2020年12月期间接受经尿道膀胱肿瘤切除术(turt)的高级别Ta、T1或原位癌(CIS)并接受BCG治疗的245例患者。采用Kaplan-Meier和Cox回归分析评估LVI和组织学亚型对无复发生存期(RFS)和无进展生存期(PFS)的影响。结果:中位随访48.5个月时,25.7%的患者检测到LVI, 36.3%的患者检测到组织学亚型。随访期间,98例(40.0%)患者出现复发,45例(18.4%)患者出现进展。在多因素分析中,LVI (HR: 2.28, 95% CI: 1.68-3.10, p)结论:在接受卡介苗治疗的高级别NMIBC患者中,LVI和组织学亚型是疾病复发和进展的强大独立危险因素。这两种因素的患者风险最高,可能需要更积极的治疗策略,包括考虑早期根治性膀胱切除术。这些发现支持了详细的病理评估在bcg治疗的NMIBC患者治疗选择中的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of lymphovascular invasion and histological variants on BCG-treated high-grade NMIBC prognosis.

Impact of lymphovascular invasion and histological variants on BCG-treated high-grade NMIBC prognosis.

Impact of lymphovascular invasion and histological variants on BCG-treated high-grade NMIBC prognosis.

Impact of lymphovascular invasion and histological variants on BCG-treated high-grade NMIBC prognosis.

Purpose: This study aimed to evaluate the impact of lymphovascular invasion (LVI) and histologic subtypes on prognosis following Bacillus Calmette-Guérin (BCG) therapy in high-grade non-muscle invasive bladder cancer (NMIBC).

Methods: We retrospectively analyzed 245 patients who underwent transurethral resection of bladder tumor (TURBT) for high-grade Ta, T1, or carcinoma in situ (CIS) and received BCG therapy between January 2010 and December 2020. Effects of LVI and histologic subtypes on recurrence-free survival (RFS) and progression-free survival (PFS) were assessed using Kaplan-Meier and Cox regression analyses.

Results: At median follow-up of 48.5 months, LVI was detected in 25.7% of patients and histologic subtypes in 36.3%. During follow-up, disease recurrence occurred in 98 patients (40.0%) and progression in 45 patients (18.4%). In multivariate analysis, LVI (HR: 2.28, 95% CI: 1.68-3.10, p < 0.001) and histologic subtypes ≥1% (HR: 1.95, 95% CI: 1.45-2.62, p < 0.001) were independent risk factors for recurrence. Similarly, LVI (HR: 2.85, 95% CI: 1.98-4.11, p < 0.001) and histologic subtypes ≥1% (HR: 2.34, 95% CI: 1.67-3.28, p < 0.001) were independent risk factors for progression. Patients with concurrent LVI and histologic subtypes demonstrated highest risk of progression (HR: 4.15, 95% CI: 2.85-6.05, p < 0.001) with 5-year PFS rate of 45.2%.

Conclusion: In high-grade NMIBC patients receiving BCG therapy, LVI and histologic subtypes are strong independent risk factors for disease recurrence and progression. Patients with both factors have highest risk and may require more aggressive treatment strategies including consideration of early radical cystectomy. These findings support the importance of detailed pathological assessment in treatment selection for BCG-treated NMIBC patients.

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来源期刊
Bladder Cancer
Bladder Cancer Medicine-Urology
CiteScore
1.60
自引率
0.00%
发文量
35
期刊介绍: Bladder Cancer is an international multidisciplinary journal to facilitate progress in understanding the epidemiology/etiology, genetics, molecular correlates, pathogenesis, pharmacology, ethics, patient advocacy and survivorship, diagnosis and treatment of tumors of the bladder and upper urinary tract. The journal publishes research reports, reviews, short communications, and letters-to-the-editor. The journal is dedicated to providing an open forum for original research in basic science, translational research and clinical medicine that expedites our fundamental understanding and improves treatment of tumors of the bladder and upper urinary tract.
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