The Recurrence Factors Of Non-muscle-invasive Bladder Cancer After Surgery

Objective This study is to construct a panoramic identification of risk factors for recurrence of non-muscular invasive bladder cancer(NMIBC)after transurethral resection of bladder tumor(TURBT)by retrospective analysis of the main influencing factors and clinical significance of postoperative recurrence of non-muscular invasive bladder cancer.Methods The clinical data of 1498 patients with non-muscular invasive bladder cancer treated with TURBT in the second hospital of Tianjin Medical University from January 2005 to December 2015 were retrospectively analyzed,including 30 indicators that Patients’ age,gender,smoking,drinking,body mass index(BMI),whether the merger chronic diseases(hypertension,diabetes,coronary heart disease,chronic kidney disease,chronic liver disease),tumor number,location of tumor,diameter of tumor,pathologic stage,histological grade,whether with squamous differentiation,immunohistochemical gene expression status(Ki67,P53,P21),prothrombin time,thrombin time,prothrombin time and uric bravery former,urine PH,uric acid content,the ALT/AST,blood albumin levels,blood leukocyte count,neutrophil lymphocyte ratio,platelet lymphocyte ratio.Mainly adopt the way of telephone follow-up,and ask patients with postoperative recurrence of bladder tumor diagnosis and treatment,etc.,to collect the required data.Using the SPSS23.0 to analyze the data.Using the Cox proportional risk regression mode to perform single factor and multiple factors analysis,then we could determine the independent risk factors for recurrence of non-muscle-invasive bladder cancer after surgery.Results To the follow-up date(December 2015),according to the seventh TNM staging method in 2009,we found 573 patients with recurrence with a total recurrence rate of38.2% and an average relapse-free survival time of 41.08 months.Among the patients with recurrence,10% of the cases were stage without invasive papillary carcinoma(Ta),and 90% were pathologic stage invasion mucosal lamina propria(T1).Single factor Cox proportional hazards model analysis results show that the patient’s BMI,tumor number,diameter of tumor,tumor stage,whether with squamous differentiation,whether with hypertension,diabetes mellitus,whether with coronary heart disease,smoking,drinking,the strength of Ki67 expression,neutral grain percentage and platelet lymphocyte ratio were associated with tumor recurrence(P<0.05);The results of the analysis of the multi-factor Cox proportional risk model showed that the BMI(P=0.008),tumor stage(P=0.000)and multiple tumor(P=0.01)were independent risk factors for recurrence of non-muscular invasive bladder cancer after TURBT.Conclusion The recurrence rate of non-muscular invasive bladder cancer after TURBT postoperative is high.The study found that BMI,tumor number,diameter of tumor,tumor stage,whether with squamous differentiation,whether with high blood pressure,diabetes mellitus,whether with coronary heart disease,smoking,drinking,the strength of Ki67 expression,neutrophil granulocyte and platelet lymphocyte ratio were associated with the recurrence of non-muscular invasive bladder cancer.By multivariate analysis,BMI,number of tumors and tumor staging are independent factors.