老年膀胱癌患者的预后影响因素分析  

Influential factors to the prognosis of senile patients with bladder cancer

作　　者：郝通利[1] 洪宝发[1] 孙东冲[1] 李刚[1] 张磊[1] 

机构地区：[1]解放军总医院泌尿外科,北京100853

出　　处：《解放军医学杂志》2009年第3期326-328,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨影响老年膀胱癌患者预后的因素。方法采用《受肿瘤影响的功能性生活指标(FLIC))》、《肿瘤一般治疗的功能性评估(FACT-G)》、《肿瘤康复评价简洁调查表(CARES-SF)》对1998年8月-2008年8月145例经病理证实为膀胱癌的老年患者进行调查和临床资料分析,选择对预后可能产生影响的多种因素进行量化,应用统计学方法分析各种因素与预后的关系。结果临床资料回顾性分析显示,从65岁开始,5岁为一个等级,患者年龄梯度与患者生存率呈正相关(r=0.687,P<0.05)。Ta-T1期患者5年生存率(85.0%,68/80)及T2期患者5年生存率(72.7%,16/22)明显高于T3期患者(50.0%,13/26)和T4期患者(0%,0/17,P<0.01)。腔内手术组5年生存率(73%,57/78)明显高于开放手术组(51%,25/49,P<0.05)。膀胱灌注组与未接受膀胱灌注组生存率比较差异无统计学意义(P=0.259)。患者心、脑、肾、肺等器官疾患的程度与死亡率呈显著正相关(P<0.01)。结论患者年龄、肿瘤分期、心肺功能是膀胱癌长期存活的危险因素,漏诊早期肿瘤、肿瘤多部位生长是术后肿瘤复发的高风险因素。Objective To investigate the influential factors to the prognosis of senile patients with bladder cancer. Methods One hundred and forty-five senile patients with bladder cancer confirmed by pathology from 1998 to 2008 were clinically investigated and ana- lyzed using measuring scales of Functional Living Index-Cancer （FLIC）, Functional Assessment of Cancer Therapy-General （FACT-G） and Cancer Rehabilitation Evaluation System short form （CARES-SF）. The factors influencing the prognosis were selected and quantified, and the relationship between the factors and prognosis was statistically analyzed. Results By retrospective analysis of clinical data, it was revealed that, suppose every 5 years from 65 were as an age grade, the age-gradient was positively correlated with the survival rates （r= 0. 687, P〈0. 05）. The 5-year survival, rates of the patients with tumor in stage Ta -T1 （85.71%, 68/80） and T2 （72. 72%, 16/22） were significantly higher than those in stage T3 （50%, 13/26） and T4 （0%, 0/17）, and of the patients undergone intravesical surgery （73%, 57/78） was significantly higher than that undergone open surgery （51%, 25/49, P〈0. 05）. However, no significant difference of 5-year survival rate was found between the patients with and without intravesieal chemotherapy groups （P= 0. 259）. The mortality was positively correlated with the severity of the dysfunction of vital organ （heart, brain, kidney and lung, etc. ） （r=0. 890, P〈0. 01）. Conclusions Age, tumor stage and cardiorespiratory function are the risk factors influencing the survival rate of patients with bladder cancer. Early missed diagnosis and tumors of multiple sites are the risk factors influencing the recurrence of the cancer.

关 键 词：膀胱肿瘤 预后 生存率 生活质量 

分 类 号：R737.14[医药卫生—肿瘤]