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膀胱癌根治术前单次动脉灌注化疗的长期疗效评估 预览 被引量:2

Long-term efficacy of one-shot intra-arterial chemotherapy before radical cystectomy
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摘要 目的评估腹腔镜膀胱癌根治(laparoscopic radical cystectomy,LRC)术前单次新辅助动脉灌注化学药物治疗(以下简称化疗)对长期预后的影响。方法回顾性分析2006年2月至2015年12月间于首都医科大学附属北京朝阳医院行LRC术前26例单次动脉灌注化疗的患者围术期临床资料和随访结果。结果 26例患者LRC术前2-4周内行动脉灌注化疗,其中回肠膀胱9例,原位回肠新膀胱15例,输尿管皮肤造口2例,无中转开放。平均手术时间373 min(210-600 min),平均术中出血量为407 mL(100-1 400 mL)。术后病理提示均为尿路上皮癌,6例低级别,20例高级别,切缘均未见肿瘤。7例临床分期与病理分期相符,降期17例,升期2例,与术前临床分期相比,单次动脉灌注化疗局部降期效果显著(P=0.002)。平均淋巴结清扫数目17个(8-28个),8例淋巴结阳性。术后30 d内的合并症发生率在低级别和高级别肿瘤之间差异无统计学意义(P=0.081)。术后30 d内,30至90 d内以及超过90 d Clavien 3级以上合并症分别为3例、1例和2例。平均随访时间88个月(2-121个月),肿瘤特异性死亡2例,其他原因死亡1例,其中低级别和高级别肿瘤之间的总生存率(P=0.746)和肿瘤特异性生存率(P=0.446)差异均无统计学意义。结论 LRC术前进行单侧动脉灌注化疗并没有明显增加术后合并症,且同时起到显著地降期降级作用,但在肿瘤学预后方面还需要随机对照研究进行评估。 Objective Evaluation of long-term outcome of one-shot intra-arterial chemotherapy as new adjuvant therapy before laparoscopic radical cystectomy( LRC). Methods We retrospectively analyzed the preoperative clinical data and follow-up results of 26 patients who received one-shot intra-arterial chemotherapy before LRC in Urology Department of Beijing Chaoyang Hospital from February2006 to December 2015. Results All patients were performed one-shot intra-arterial chemotherapy 2-4 weeks before the LRC and completed laparoscopic procedure without open conversion( ileal conduit urinary diversion for 9 patients,orthotopic ileal neobladder for 15 patients and cutaneous ureterostomy for 2 patients). The average operation time was 373 min( 210-600 min) with estimated blood loss of 407 mL( 100-1 400 mL). All pathology was urothelial cell carcinoma of the urinary bladder with 6 low grade and 20 high grade. No positive surgical margins were reported. Compared with clinical TNM stages,pathological TNM stages demonstrated significant decrease( P = 0. 002) : 7 cases had no changed,17 cases achieved a stage decrease,and 2 cases had risen. The average lymph node number was17( 8-28) including 8 positive cases. There was no statistical difference in 30-day postoperative complications between the low grade and high grade tumor( P = 0. 081). The number of Clavien level 3 or higher complications within 30 day,30 to 90 days,and more than90 days were 3 cases,1 case and 2 cases,respectively. The patients were followed up for 88 months( 2-121 months). There were two cancer-specific deaths and one died of other causes during the follow-up period; however,no difference was found in terms of overall survival( P = 0. 746) and cancer specific survival( P = 0. 446) between the low grade and high grade tumor. Conclusion With long-termfollow-up,one-shot intra-arterial chemotherapy did not significantly increase the post-operative complications, at the same time significantly decreased the pathological stage
作者 瓦斯里江·瓦哈甫 刘赛 王梦童 贺庆豹 宋黎明 平浩 王明帅 杨飞亚 田溪泉 牛亦农 邢念增 Wasilijiang·Wahafu, Liu Sai, Wang Mengtong,He Qingbao,Song Liming,Ping Hao,Wang Mingshuai,Yang Feiya, Tian Xiquan,Niu Yinong,Xing Nianzeng ( Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China )
出处 《首都医科大学学报》 北大核心 2018年第3期418-422,共5页 Journal of Capital University of Medical Sciences
基金 北京市医院管理局“青苗”计划专项经费资助(QML20160303) 首都医科大学附属北京朝阳医院1351人才培养计划项目资助(CYXX-2017-11).
关键词 膀胱癌 动脉灌注化疗 预后 bladder cancer intra-arterial chemotherapy outcomes
作者简介 Corresponding author, E-mail:nianzeng2006@vip.sina.com
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  • 1刘卓炜,周芳坚,余绍龙,秦自科,韩辉,王斌,王欢,李永红.动脉化疗治疗低分化膀胱移行细胞癌的初步临床疗效[J].癌症:英文版,2004(z1):1517-1519. 被引量:3
  • 2余绍龙,周芳坚,秦自科,韩辉,刘卓炜,王斌,王欢,李永红.移行细胞癌盆腔复发动脉化疗的疗效观察[J].中华泌尿外科杂志,2005,26(10):689-691. 被引量:4
  • 3Sonpavde G, Petrylak DP. Perioperative chemotherapy for bladder cancer. Crit Rev Oncol Hematol, 2006, 57:133- 144. 被引量:1
  • 4vonder Maase H, Hansen SW, Roberts JT, et al. Gemcitabine and cisplatin versus methotrexate, vinblastine, doxorubicin, and cisplatin in advanced or metastatic bladder cancer: results of a large, randomized, multinational, multicenter, phase Ⅲ study. J Clin Oncol, 2000, 18: 3068-3077. 被引量:1
  • 5yon der Maase H, Sengelov L, Roberts JT, et al. Long-term survival results of a randomized trial comparing gemcitabine plus cisplatin, with methotrexate, vinblastine, doxorubicin, plus cisplatin in patients with bladder cancer. J Clin Oncol, 2005, 23: 4602-4608. 被引量:1
  • 6Advanced Bladder Cancer (ABC) Meta-analysis Collaboration.Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta analysis of individual patient data advanced bladder cancer. Eur Urol, 2005, 48: 202-205. 被引量:1
  • 7Winquist E, Kirchner TS, Segal R, et al, Genitourinary Cancer Disease Site Group, Cancer Care Ontario Program in Evidence-based Care Practice Guidelines Initiative. Neoadjuvant chemotherapy for transitional cell carcinoma of the blad der: a systematic review and recta-analysis. J Urol, 2004, 171 :561-569. 被引量:1
  • 8Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cysteetorny alone for locally advanced bladder cancer. N Engl J Med, 2003, 349: 859-866. 被引量:1
  • 9Herchenhorn D, Dienstmann R, Peixoto FA, et al. Phase II trial of neoadjuvant gemcitabine and cisplatin in patients with resectable bladder carcinoma. Int Braz J Urol, 2007, 33: 630- 638. 被引量:1
  • 10Herr HW, Bajorin DF, Scher HI. Neoadjuvant chemotherapy and bladder sparing surgery for invasive bladder cancer: ten year outcome. J Clin Oncol, 1998, 16: 1298-1301. 被引量:1

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