Retrospect The Prognosis Of Bladder Cancer And The Influence Of Smoking On The Prognosis Of Non-muscle-invasive Bladder Cancer

Objective:1. Follow up the bladder cancer patients in our hospital, analysis the influence of the feature of cancer to the prognosis;2. Compare the therapeutic effect of different operation methods to muscle-invasive bladder cancer;3. Review the assistant effect of epirubicin to non-muscle invasive bladder cancer;4. Evaluate the influence of smoking to the prognosis of non-muscle-invasive bladder cancer.Methods:364patients with non-muscle-invasive bladder tumor between2006-06to2011-12were followed up.328patients with non-muscle invasive bladder cancer and21cases with muscle invasive bladder cancer were treated with TURBT,6cases with muscle-invasive bladder cancer were treated with partial bladder resection and9cases with muscle-invasive bladder cancer were treated with radical resection of the bladder. Bladder irrigation was performed among the patients treated with bladder preserving operation. The agents include doxorubicin, epirubicin, plrarubicin, mitomycin and hydroxycamptothecine. All patients in epirubicin-treated group were divided into two groups:smoking group and non-smoking group. The patients in smoking group were divided into continues-smoking group and stop-smoking group. Measurement data was analyzed by using t test. The comparison of recurrence rate was analyzed by using χ test. Logistic regression was used for recurrence rate. Survival data was analyzed by using COX test.Results:Grades (P<0.001)、the number of tumor (P=0.032) and recurrence (P=0.046) were associated with recurrence in patients with non-muscle-invasive bladder tumor. The higher EORTC scores, the higher rate of recurrence. For muscle-invasive bladder cancer, recurrence free survival rate of the patients who underwent radical cystectomy was higher than that of bladder preserving operation (P<0.05), while partial resection of bladder recurrence-free survival rate was higher than that of TURBT (P<0.05). There was no significant difference in2-yr survival rate among three kinds of operations. For non-muscle-invasive bladder cancer treated with epirubicin,1-yr recurrence rate was4%and2-yr recurrence rate was17.2%. Among patients treated with epirubicin, smoking rate of male patients was higher than that of female patients (P<0.001). There were more patients with multiple tumors in non-smoking group (P=0.001). The recurrent rate of smoking group was higher than non-smoking group (OR=4.033, P=0.001). The recurrence rate of continues-smoking was higher than that of stop-smoking group while the difference had no significance. Recurrence-free survival time was significantly shorter in smoking group (OR=0.311, P=0.002). Continues-smoking group and stop-smoking group had no significant difference in recurrence-free survival time (P>0.05).Conclusion:Grades, the number of tumor, recurrence, tumor size are prognosis factors of bladder cancer. Radical cystectomy can improve the recurrence-free survival rate of patient but has no significant difference when compared with bladder preservation operation. Epirubicin can reduce the recurrence rate of bladder tumor effectively while the scheme of irrigation should be chosen according to the patient individually. Smoking status is a prognosis factor for bladder tumor. Postoperative changes in smoking habits may improve the prognosis. The relationship between smoke and tumor characteristics such as tumor size, stage, grade needs more study.