Risk Analysis Of Recurrence Of Male Non-muscle Invasive Bladder Cancer

Objective:Bladder Cancer is the most common urologic cancer in the world.According to the 2018 survey,Bladder Cancer is the 10th most common cancer all around the world,but it is the 6th most common cancer in male and 15th behind in females.The prognosis of male patients with bladder cancer of the same stage is better than that of female patients.It can be seen that bladder cancer has a significant gender difference.The most common type of bladder cancer is non-muscular invasive bladder cancer(NMIBC).The gold standard for the treatment of NMIBC is transurethral resection of bladder tumor(TURBT).However,due to the characteristic of multi-center bladder cancer and easy recurrence after surgery,it has brought great troubles to clinicians and patients.Currently,there are few studies on single-sex bladder cancer.This study aims to provide more accurate guidance for the further diagnosis and treatment of NMIBC and the evaluation of its prognosis by studying the related factors of recurrence after TURBT in male patients.Methods:For retrospective analysis research,we choose the male NMIBC patient who was first diagnosed in Shandong Province hospital.We collect preoperative clinical information and follow-up survey,respectively for the patients with smoking history,tumor size,tumor shape,T staging of tumor,tumor pathologic type,prostate volume,preoperative urine red blood cell count,neutrophils to lymphocytes ratio,platelet to lymphocyte ratio was analyzed by Kapaln-meier method for its recurrence free survival,and its effect on recurrence free survival of bladder tumors was obtained.Cox proportional risk model was used to further analyze the risk factors affecting the recurrence of non-muscular invasive bladder cancer in male.Results:the median follow-up time of 115 male patients with non-muscle invasive bladder cancer(NMIBC)was 42 months.23 patients(20.0%)had tumor recurrence.The 1-year,3-year,5-year recurrence free survival rates were 88.7%,81.2%,and 76.8%.The shortest recurrence time was 3 months and the longest was 51 months.Prostate volume,preoperative routine urine red blood cell count,platelet-to-lymphocyte ratio(PLR)and Neutrophil to lymphocyte rate(NLR)were calculated as continuous variables and bladder cancer recurrence.Receiver operating characteristic curve was plotted.The area under the curve is 0.542,0.653,0.509 and 0.513 and get their best "cut-off" point,respectively.Kaplan-meier method was used to analyze the relationship between single factor and recurrence free survival after surgery in male NMIBC patients.It was found that the size(P=0.046),number(P=0.007),pathological stage(P=0.008),grade(P=0.000)and preoperative routine urine red blood cell count(P=0.003)of bladder tumor were correlated with postoperative recurrence.The above variables were taken into COX multivariate analysis.Using the method of backwalder,it was found that preoperative routine urine red blood cell count(P=0.034)and histopatological grade of high grade papillary urothelial carcinoma(P=0.033)were independent risk factors for NMIBC recurrence in male.Conclusions:1.In male NMIBC patients,the pathological grade of low-grade urothelial cancer was the most common,and the cancer T grade of stage Ta patients was the most common.2.Preoperative urine routine red blood cell count,tumor size,number,pathological grade and T stage were the relevant factors affecting postoperative recurrence in male NMIBC patients.3.Age and prostate size are not related factors for postoperative recurrence in male NMIBC patients.The value of NLR and PLR in predicting the risk of postoperative recurrence in male NMIBC patients is small.4.Preoperative routine urine red blood cell count and tumor pathological grading were independent risk factors for postoperative recurrence in male NMIBC patients.5.Patients with preoperative routine urine red blood cell count? 200/? L and high grade urothelial carcinomacarcinoma have a higher risk of recurrence.For such patients,more active and rigorous surgery should be adopted,the follow-up should be strengthened,the bladder perfusion should be treated regularly,and the second surgical treatment should be performed if necessary.