目的: 研究上尿路尿路上皮肿瘤根治术后无瘤生存期的影响因素。方法: 选取2012年3月~2014年3月730例上尿路尿路上皮肿瘤患者为研究对象,所有患者均接受根治性手术治疗。收集患者临床及病理资料,术后对患者进行为期3年随访,以术后影像学检查发现复发灶或患者死亡为无瘤生存终点,统计3年内无瘤生存率。结果: 730例患者中有效随访人数702例,其中死亡69例,复发101例,无瘤生存患者532例,3年无瘤生存率75.8%(532/702)。无瘤生存期≥3年组年龄≥60岁、女性、肿瘤直径≥3 cm、肿瘤数量≥2个、TNM分期Ⅲ~Ⅳ期、WHO分级高级别、合并肾积水患者比例显著低于无瘤生存期<3年组( P<0.05),患侧、肿瘤部位、淋巴结清扫与无瘤生存期<3年组比较差异无统计学意义( P>0.05)。Logistic回归分析结果显示,TNM分期、WHO分级、肾积水为上尿路尿路上皮肿瘤根治术后无瘤生存期独立影响因素。结论: 年龄、性别、肿瘤直径、肿瘤数量、TNM分期、WHO分级、是否合并肾积水等7个因素对上尿路尿路上皮肿瘤根治术后无瘤生存期有显著影响。

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.