Abstract：Objective: To investigate the influencing factors of tumor-free survival after radical resection of upper urinary tract urothelial carcinoma. Methods: 730 patients with upper urinary tract urothelial carcinomas who were admitted to our hospital from March 2012 to March 2014 were selected as the subjects, and all patients were treated by radical resection. The clinical and pathological data of the patients were collected, and the patients were followed up for 3 years after operation. The occurrence of recurrence or death found by imaging examination was taken as the endpoint of tumor-free survival, and the tumor-free survival rate within 3 years was statistically analyzed. Results: In the 730 patients, 702 were followed up effectively, including 69 death cases, 101 recurrent cases and 532 tumor-free survival cases, and the 3-year tumor-free survival rate was 75.8% (532/702). The proportions of patients who were or older than 60 years old, who were female, whose tumor diameter was or longer than 3 cm, who had 2 or more than 2 tumors, who had tumors at TNM stage Ⅲ-Ⅳ, high WHO grade and who had hydronephrosis in the tumor-free survival ≥ 3 years group was significantly lower than those in the tumor-free survival <3 years group (P<0.05). No significant differences were found in the affected side, tumor location or lymph node dissection between the two groups (P>0.05). Logistic regression analysis showed that tumor stage, differentiation degree and hydronephrosis were independent influencing factors of tumor-free survival after radical resection of upper urinary tract urothelial carcinoma. Conclusions: Age, gender, the diameter and number of tumors, TNM stage, WHO grading and hydronephrosis have significant influence on the tumor-free survival after radical resection of upper urinary tract urothelial carcinoma.
[1] 袁道彰,都兴华,石利平,等.经腹腹腔镜与后腹腔镜治疗上尿路尿路上皮癌的比较研究.中国微创外科杂志,2016,16(9):812-815. [2] Hahn AW, Giri S, Pathak R, et al.Effect of adjuvant radiotherapy on survival in patients with locoregional urothelial malignancies of the upper urinary tract. Anticancer Res, 2016,36(8):4051-4055. [3] 梁成才,钱苏波,张林,等.上尿路尿路上皮癌伴鳞状或腺样分化的临床特点及预后分析.中华泌尿外科杂志,2017,38(8):595-599. [4] 汤钊猷. 现代肿瘤学.2版.上海:上海医科大学出版社,2000:1154-1158. [5] 牛育鸿,董靖.肿瘤抑制基因与衰老的研究进展.基因组学与应用生物学,2015,34(7):1549-1554. [6] Mohamad Al-Ali B, Madersbacher S, Zielonke N, et al. Impact of gender on tumor stage and survival of upper urinary tract urothelial cancer: A population-based study. Wien Klin Wochenschr, 2017,129(11-12):385-390. [7] 李乐,孙备,张广权,等.影响胰腺囊性肿瘤良恶性及预后的危险因素分析.中华消化外科杂志,2016,15(6):562-566. [8] 刘尚国,齐博,赵宝生,等.相同病理分期食管癌患者预后影响因素分析.中国现代医学杂志,2015,25(36):93-96. [9] 张彩祥,丰琅,田野.上尿路尿路上皮癌患者肾输尿管全长切除术后再发膀胱癌的危险因素分析.中华泌尿外科杂志,2016,37(7):488-492. [10] 田磊,肖秀英,叶明.残胃癌的临床病理特征及预后分析.肿瘤,2015,35(3):301-311. [11] 马莉,杨燕.影像学检测肿瘤直径和淋巴结转移在宫颈癌患者预后中的价值研究.中国现代医学杂志,2016,26(18):94-99. [12] 王卡娜,刘辉,侯敏敏,等.42例卵巢恶性生殖细胞肿瘤临床特征及预后分析.实用妇产科杂志,2015,31(1):40-44. [13] Yamashita S, Ito A, Mitsuzuka K, et al.Impact of relapse site on oncological outcomes after radical nephroureterectomy for upper urinary tract urothelial carcinoma. J Clin Oncol, 2016, 34(2s):426. [14] 李丹. 影响腹腔镜结肠癌切除术患者预后的危险因素分析.医学临床研究,2015,32(4):668-670, 674. [15] Yan SB, Liu LR, Wei Q, et al.Impact of tumour size on prognosis of upper urinary tract urothelial carcinoma after radical nephroureterectomy: a multi-institutional analysis of 795 cases. BJU Int, 2016,118(6):902-910. [16] 邢云超,熊耕砚,方东,等.非肌层浸润性上尿路尿路上皮癌5年随访生存分析及其预后相关因素研究.中华泌尿外科杂志,2016,37(3):190-194. [17] 刘彬,李文贤,肖慧敏,等.上尿路尿路上皮癌根治术后尿路外复发的临床特点及危险因素分析.中华泌尿外科杂志,2016,37(10):740-744. [18] 王跃,贺慧颖.上尿路尿路上皮癌368例根治标本的临床病理特点及预后分析.中华病理学杂志,2016,45(10):681-686. [19] Sasaki K, Wada K, Araki M, et al.Diagnostic ureteroscopy for cases clinically suspected of carcinoma in situ of the upper urinary tract. Acta Med Okayama, 2017,71(3):227-232.
