Prognostic Multivariate Analysis Of Upper Urothelial Carcinoma And Risk Factors Analysis Of Recurrent Bladder Cancer After Radical Nephroureterectomy

Objective To determine the prognostic factors of patients with UTUC after radical surgery,and to explore the risk factors that may predict postoperative bladder recurrence in patients with UTUC,so as to provide a more scientific basis for the treatment and prevention of bladder recurrence in patients with upper urothelial carcinoma.Methods The data of 88 patients admitted to our hospital from January 2010 to January 2020 who underwent RNU surgery and were identified as urothelial carcinoma by postoperative pathology were analyzed.Cox proportional risk regression model was used to analyze the prognostic independent risk factors and related factors affecting bladder cancer recurrence in patients with UTUC.Results In this study,88 patients were included,including 50males(56.8%)and 38 females(43.2%),with an average age of 63.5 years.61 cases of renal pelvis carcinoma(69.3%)and 27 cases of ureteral carcinoma(30.7%)were found.A total of 29 patients(33.0%)were complicated with hydronephrosis before surgery,and 10patients(11.4%)had a history of bladder cancer.There were 58 cases(65.9%)of T1-T2 and 30 cases(36.1%)of T3-T4.There were 28 cases(31.8%)of lymphatic vascular invasion,32 cases(36.4%)of postoperative bladder perfusion,and 78 cases(88.6%)of patients with bladder cancer history.Tumor recurrence occurred in 38 patients(43.2%),and the mean follow-up time was 46.9 months.Risk factors for the prognosis of UTUC include gender,preoperative hydronephrosis,lymphatic vascular invasion,and T3/T4 stage of the tumor.Factors influencing the recurrence of bladder cancer after RNU surgery include gender,ureteral cancer,previous history of bladder cancer,tumor T3/T4 staging,and regular postoperative bladder perfusion,etc.Conclusion 1.The postoperative survival time of patients with early UTUC was longer than that of patients with late UTUC,and early intervention treatment could prolong the survival time of patients with UTUC.2.Female,lymphatic vascular invasion,preoperative combined with hydronephrosis,and tumor T3/T4 staging were independent risk factors affecting the prognosis and survival of patients with UTUC.3.Female,ureteral cancer,previous history of bladder cancer,tumor T3/T4 staging is a risk factor for postoperative recurrence of bladder cancer,while regular postoperative bladder perfusion is a protective factor for RNU.