Analysis Of Prognostic Factors For Radical Cystectomy In Patients With T1 Bladder Cancer

Intention: T1 bladder cancer accounts for more than 45% of patients with non-muscle invasive bladder cancer,and more than 90% is of high grade.Among them,within 5 years after transurethral resection of bladder tumors,30% progress to muscle infiltration Bladder Cancer.If it is simply treated as "superficial bladder cancer"(such as p Ta stage),the prognosis of patients is undoubtedly poor.On the contrary,if these patients undergo early radical cystectomy,they may benefit greatly.Therefore,it is important to evaluate patients with T1 stage bladder cancer who are clinically unsuitable for transurethral resection of bladder tumors,identify the patient population suitable for early radical cystectomy,and analyze the relevant risk factors that affect their postoperative survival In order to help the urological surgeon to predict the risk of tumor recurrence and progression after bladder treatment by analyzing related risk factors,so as to choose the appropriate treatment plan and benefit more patients.Methods: To retrospectively analyze the data of 114 patients with stage T1 bladder cancer who underwent radical cystectomy at the Second Hospital of Tianjin Medical University from 2000 to 2010,and analyze the clinicopathological characteristics including age,histological grade,lymphatic infiltration and The relationship between multi-factors such as pelvic lymph node status and postoperative survival,multi-factor COX and other risk models were used to analyze its effect on cancer-specific survival(CSS)and overall survival(OS).And to explore other clinical,tumor,and pathological risk factors related to the recurrence and progression of patients with T1 bladder cancer except this study.Results: The patient’s age,lymphatic vessel infiltration and pelvic lymph node status were significantly correlated with the survival rate after radical cystectomy in patients with p T1 bladder cancer.Patients with recurrent high-grade p T1 bladder cancer tend to have worse CSS than patients with initial or recurrent low-grade p T1 bladder cancer(the 5-year and 10-year CSS incidence rates for the initial cases are 75% and 73%,respectively;the recurrence is low Grade p T1 bladder cancer was 77% and 77%;recurrent high-grade p T1 bladder cancer was 56% and 37%,p = 0.078).Conclusion: The patient’s age,lymphatic vessel infiltration and lymph node metastasis are significantly correlated with postoperative survival rate of patients with p T1 bladder cancer.In view of the poor CSS after radical cystectomy in these cases,radical cystectomy should be performed in time,even if it does not progress to muscle-invasive bladder cancer.Tumor diameter> 3cm,complex tumor location,difficult to completely remove the tumor,accompanied by CIS is a high-risk factor for the recurrence and progression of T1 bladder cancer patients,patients with one or more of the above clinical or pathological features,early cystectomy may benefit.