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术后复发风险因素

发表时间:2018-12-3  浏览次数:49  
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原文:

While overall outcomes have not been linked to a partial versus a complete cystectomy, appropriate surgical management can have a substantial impact on longterm survival. As noted previously, achieving negative margins improves survival, with few long-term survivors beyond 3–5 years in the setting of positive surgical margins. These two separate singleinstitution studies also report that partial cystectomy with en bloc resection of the urachal ligament and umbilicus led to more long-term survivors [3,5]. Peritoneal carcinomatosis also has an adverse impact on outcome. In addition, the presence of lymph node or other metastasis at the time of the surgery also led to poor outcomes. Our experience at MDACC is that patients with lymph node metastasis have avirtually indistinguishable course compared with those patients with more distant metastasis. We have not observed any long-term survivors in this setting.

译文:

术后总体转归与实施部分切除还是膀胱全部切除术相关,因此适当的手术管理与患者长期生存期密切相关。正如此前所阐述,手术切缘无肿瘤细胞时大大提高患者术后生存期,很少有患者在手术切缘有肿瘤细胞的情况下生存期超过3-5年。这两个独立的单中心研究还报道,实施部分膀胱切除术(整体切除脐尿管韧带和脐部),可延长患者生存期。同时,腹膜癌转移将导致生存期缩短。另外,手术时淋巴结转移或其他转移也会影响手术效果。我们的经验是:淋巴结转移患者与远端转移患者相比疗效并没有实质区别。针对该种转移病情,我们未发现任何长期生存者。

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