| ObjectiveBladder cancer is the most common genitourinary tumor in China,which ranks seventh in the incidence of male malignant tumors in our country,which have many tissue types of bladder cancer,such as epithelial origin and non-epithelial origin,tumors with epithelial origin include urothelial carcinoma,squamous cell carcinoma,adenocarcinoma,sarcomatoid carcinoma and neuroendocrine tumor.tumors with non-epithelial origin include sarcoma,paraganglioma,melanoma and lymphoma.Bladder squamous cell carcinoma(BSCC)is a rare bladder malignant tumor with high degree,a late stage,and a poor prognosis.It accounts for about 2%to 5%of bladder malignancies.It has schistosomiasis and There are two subtypes of non-schistosomiasis BSCC,both of which have different epidemiological and clinicopathological characteristics.All 63 cases in this article are non-schistosomiasis BSCC.Due to the low incidence of BSCC,most of the published data are currently studying the epidemiological characteristics of BSCC.There is not much evidence-based medicine evidence for the treatment of this type of disease.We conducted survival analysis based on single center clinical datas to figure out the association between different clinicopathological features,treatment methods and survival prognosis of BSCC,so as to provide some references for BSCC treatment.Subjects and methodsPatients with BSCC(no history of schistosomiasis contact)diagnosed by biopsy or postoperative pathology in our center from August 2011 to January 2019.Among them,the surgical patients were evaluated before operation without surgical taboos and were treated by the deputy director of the center and above doctors.Among the 63 patients treated in this study,whch have 46 males and 17 females,and the ratio of them was 2.71,the age was from 29 to 85,and the median age of onset was 69.0 years old;maximum tumor diameter is 20-102 mm,median tumor maximum diameter is 44.00 mm,BSCC can be divided into schistosomiasis and non-schistosomiasis BSCC,the two have different epidemiology based on the clinical and pathological characteristics,all the 63 patients in this study had no history of exposure to schistosomiasis,and us all were non-schistosomiasis BSCC,analysing the effects of clinicopathological features on survival time and prognosis(Table 1).Using SPSS 22.0 statistical software,the endpoint of the study was overall survival.The Kaplan-Meier method and Log-Rank method were used to analyze and compare the survival rate in univariate survival analysis,and then the P<0.1 index was analyzed by Cox regression model to test.The level α=0.05.ResultsThe follow-up time and median follow-up time of 63 patients were 6～89 months and 28.0 months,respectively,the 1-year overall survival rate was 82.5%,the 3-year overall survival rate was 54.9%,and the 5-year overall survival rate was 34.2%.,with a median survival time of 38.0 months.The Log-Rank test was used to screen the identified single factors,and a total of 5 factors affecting the survival time of BSCC patients were screened at the level of α=0.05,which were surgical methods(P<0.001)and postoperative chemotherapy(P=0.024),Lymph node involvement(P<0.001),distant metastasis(P<0.001)and pT staging(P<0.001).Cox multivariate analysis showed pT3～pT4 staging(HR=2.609,95%CI=1.085～6.227,P=0.032),distant metastasis(HR=3.514,95%CI=1.277～9.668,P=0.015),other surgical methods(HR=3.043,95%CI=1.281～7.231,P=0.012)are the factors affecting the survival time of BSCC patients Independent risk factors.ConclusionBSCC has poor prognosis in bladder malignant tumor.It has a late stage and high pathological grade when first diagnosed.The preferred treatment method is radical cystectomy.The clinical significance of radiotherapy and chemotherapy still needs to be further demonstrated.pT3～pT4 staging,distant metastasis,and other surgical methods are the factors affecting the survival time of BSCC patients Independent risk factors. |
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