两种手术方式对T2～T3肌层浸润性膀胱癌患者的远期疗效的影响
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摘要
目的探讨两种手术方式对T2～T3肌层浸润性膀胱癌患者的术后生活质量和远期疗效的影响。方法选取T2～T3肌层浸润性膀胱癌患者61例进行回顾性分析,按照手术方式不同分为两组,A组采用膀胱部分切除术,共31例,B组采用根治性膀胱切除术,共30例。比较两组患者的术后生活质量及不同分期的远期生存率。结果 A组患者生活质量各维度评分均显著高于B组(P <0. 05); B组中T2期患者的1年生存率、3年生存率和5年生存率与A组相比无显著性差异(P>0. 05); B组中T3期患者的1年生存率和3年生存率与A组相比无显著性差异(P>0. 05),但B组的5年生存率显著高于A组(P <0. 05); B组所有患者1年生存率与A组相比无统计学差异(P> 0. 05),但3年生存率和5年生存率均显著高于A组(P <0. 05)。结论部分膀胱切除术患者的术后生活质量明显优于根治性膀胱切除术,但对于T3期患者根治性膀胱切除术的5年生存率较高,而对于T2期患者两种手术方式的远期生存率无显著性差异,可为临床手术方式的选择提供参考。
Objective To explore the effect of two surgical methods on postoperative quality of life and long-term effect of patients with infiltrating bladder cancer( T2 ～ T3). Methods 61 patients with invasive bladder cancer( T2 ～ T3) were selected in our hospital,and divided into two groups according to the operation way. Total of 31 patients underwent partial cystectomy in group A,and total of 30 patients underwent radical cystectomy in group B. The postoperative quality of life and the long-term survival rate of different stages were compared between the two groups. Results The quality of life of patients in group A was significantly higher than that in group B( P < 0. 05). The 1-year survival rate,3-year survival rate and 5-year survival rate of T2 patients in group B had no significant difference compared with group A( P > 0. 05). The 1-year survival rate and 3-year survival rate of T3 patients in group B had no significant difference compared with group A( P > 0. 05),but the 5-year survival rate in group B was significantly higher than that in group A( P < 0. 05). The 1-year survival rate of all patients in group B was not statistically significant compared with group A( P > 0. 05),but the 3 years survival rate and 5-year survival rate were significantly higher than that of group A( P < 0. 05). Conclusion The postoperative life quality of patients with partial cystectomy was significantly better than that of radical cystectomy. But for the 5-year survival rate of patients with T3 radical cystectomy is higher,while for T2 two operation methods with no significant differences,can provide reference for the choice of the ways of clinical surgery.
Objective To explore the effect of two surgical methods on postoperative quality of life and long-term effect of patients with infiltrating bladder cancer( T2 ～ T3). Methods 61 patients with invasive bladder cancer( T2 ～ T3) were selected in our hospital,and divided into two groups according to the operation way. Total of 31 patients underwent partial cystectomy in group A,and total of 30 patients underwent radical cystectomy in group B. The postoperative quality of life and the long-term survival rate of different stages were compared between the two groups. Results The quality of life of patients in group A was significantly higher than that in group B( P < 0. 05). The 1-year survival rate,3-year survival rate and 5-year survival rate of T2 patients in group B had no significant difference compared with group A( P > 0. 05). The 1-year survival rate and 3-year survival rate of T3 patients in group B had no significant difference compared with group A( P > 0. 05),but the 5-year survival rate in group B was significantly higher than that in group A( P < 0. 05). The 1-year survival rate of all patients in group B was not statistically significant compared with group A( P > 0. 05),but the 3 years survival rate and 5-year survival rate were significantly higher than that of group A( P < 0. 05). Conclusion The postoperative life quality of patients with partial cystectomy was significantly better than that of radical cystectomy. But for the 5-year survival rate of patients with T3 radical cystectomy is higher,while for T2 two operation methods with no significant differences,can provide reference for the choice of the ways of clinical surgery.
引文
[1]张硕,赵向荣,于甬华.放疗在肌层浸润性膀胱癌治疗中的应用进展〔J〕.中华泌尿外科杂志,2016,37(2):154-157.
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[6]何乾,张国辉.保留膀胱的综合治疗与根治性膀胱切除术对肌层浸润性膀胱癌疗效的比较〔J〕.癌症进展,2017,15(3):334-337.
[7]曾蜀雄,张振声,宋瑞祥,等.腹腔镜下与开放式根治性膀胱切除术后早期并发症的对比研究〔J〕.中华泌尿外科杂志,2015,36(5). 333-336.
[8]李壮志,李俊平,刘周强,等.腹腔镜保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术的临床效果观察〔J〕.临床泌尿外科杂志,2017,32(5):397-399.
[9]白云金,杨玉帛,韩平,等.腹腔镜与开放性根治性膀胱切除术治疗老年膀胱癌短期疗效对比研究〔J〕.现代泌尿外科杂志,2016,21(2):87-90.
[2]王晓东,王元林,石华,等.腹腔镜与开放手术方式根治性膀胱切除术治疗膀胱癌的临床研究〔J〕.中国内镜杂志,2016,22(2):42-45.
[3]陈建军,边家盛.根治性经尿道电切联合化疗治疗肌层浸润性膀胱癌的临床疗效观察〔J〕.中华肿瘤防治杂志,2016,23(17):1189-1191.
[4]张志华,郭柏鸿,王新平,等.腹腔镜根治性膀胱切除术加原位回肠新膀胱术治疗膀胱癌的远期预后〔J〕.中国肿瘤临床与康复,2017(2):154-157.
[5]余昆,代林,刘胜,等.膀胱部分切除术与根治性全膀胱切除术治疗局限性肌层浸润性膀胱癌的临床分析〔J〕.第三军医大学学报,2018,40(2):169-175.
[6]何乾,张国辉.保留膀胱的综合治疗与根治性膀胱切除术对肌层浸润性膀胱癌疗效的比较〔J〕.癌症进展,2017,15(3):334-337.
[7]曾蜀雄,张振声,宋瑞祥,等.腹腔镜下与开放式根治性膀胱切除术后早期并发症的对比研究〔J〕.中华泌尿外科杂志,2015,36(5). 333-336.
[8]李壮志,李俊平,刘周强,等.腹腔镜保留部分前列腺包膜的膀胱根治性切除-原位回肠新膀胱术的临床效果观察〔J〕.临床泌尿外科杂志,2017,32(5):397-399.
[9]白云金,杨玉帛,韩平,等.腹腔镜与开放性根治性膀胱切除术治疗老年膀胱癌短期疗效对比研究〔J〕.现代泌尿外科杂志,2016,21(2):87-90.