Analysis The Influencing Factors Of T1 High Grade Urothelial Carcinoma With Recurrence And The Effect Of Systemic Chemotherapy

Objective :To investigate the facters influencing the recurrence of patients with T1 high grade urothelial carcinoma,and to evaluate the clinical effect of gemcitabine with oxaliplatin combined with systemic chemotherapy for prevention after resection.Methods :cases of T1 high grade urothelial carcinoma patients were analysis retrospectively.Age,gender,tumer of number and size,history of bladder carcinoma,smoking history were tested by X2 test,single and multivariate analysis.Patients after bladder sparing surgery were divided into two groups: All patients intravesically after surgery in 24 hours.39 cases received Intravesically after bladder sparing surgery 2 weeks,once a week for 8 weeks, and then once a month till 2years.24 cases received intravesically and systemic chemotherapy,the patients received the same protocol of in travesical,sistemic chemotherapy after surgery every 21 days by GC program, generally 3~4 courses: the patients received gemcitabine 1000mg/㎡ on day 1 and day 8 and oxaliplatin 130mg/㎡ on day 2 by intravenous infusion with 21 days as one cycle.All patients followed up of 13~52 months,through statistical analysis to compare two groups of patients with a recurrence rate and progression rate. Depicted disease-free survival curves.Results :With a median follow-up of 26.5 months,21 cases of recurrence,the recurrence time mainly in 2 years,the recurrence rate was 33.3%.COX multivariate regression analysis showed that tumor size, smoking history, and postoperative adjuvant therapy associated with tumor recurrence.Postoperative intravesical chemotherapy alonegroup, the recurrence rate was 43.6%, the progression rate of 21.0%, combined with intravesical chemotherapy after recurrence rate was 19.0%, the progression rate is zero.Systemic chemotherapy group and the control group, the difference was significant(P <0.05).Conclusions :Bladder carcinoma prognosis multifaceted impacted by tumor grade, stage, size, number, smoking status and treatment programs.T1 high grade urothelial carcinoma TURBt + intravesical treatment still with a high recurrence rate and progression rate. TURBt +intravesical+systemic chemotherapy can effectively reduce the rate of tumor recurrence and progression rates, and fewer side effects,achieved a better therapeutic effect.