Multivariate Analysis Of Prognosis Of Upper Urinary Tract Urothelial Carcinoma And Risk Factors For Recurrence Of Bladder Cancer After Operation

Objective:Upper urinary tract urothelial carcinoma(UTUC)is a kind of urinary malignant tumor with high mortality and high recurrence rate,which seriously threatens the life of patients,including transitional cell carcinoma of the renal pelvis or transitional cell carcinoma of the ureter,accounting for about 5%-10% of all urothelial carcinoma.At present,there are few studies on survival,prognostic risk factors and risk factors of bladder recurrence in patients with upper urinary tract carcinoma.The purpose of this study was to analyze the survival rate,prognostic risk factors and risk factors of bladder recurrence in UTUC patients by using univariate and multivariate COX proportional hazard regression model and logistic regression analysis.The survival status,adverse prognostic factors and factors affecting bladder recurrence in UTUC patients were retrospectively analyzed.Therefore,we hope to provide a more scientific basis for the prevention and treatment of upper urinary tract epithelial cancer.Method:1.determine the object of research that meets the standardsFrom March 2011 to August 2017,the medical records of patients with upper urinary tract urothelial carcinoma(UTUC)admitted to our urology department were analyzed.The data of patients with UTUC were collected one by one.Urinary tract urothelial carcinoma(UTUC)was registered one by one in terms of name,sex,age,admission time,medical record number,family address,telephone number,smoking,use of Chinese medicines containing aristolochic acid(Pai Shi granule、Platoon stone soup、bolus of gentian for purging liver-fire),lymph node metastasis,previous bladder cancer,tumor location,tumor size,tumor type,and tumor size.Tumor stage,grade,pathological number,preoperative ureteroscopy,operation method,operation time,hospital stay and postoperative bladder instillation of drugs.2.follow upThe collected patients were followed up by the following ways: 1.telephone follow-up;2;network follow-up;3.regular bladder perfusion follow-up;4.outpatient follow-up 5,combined with the hospital ward Jiahe case system follow-up.The primary follow-up included postoperative survival,disease progression,recurrence of bladder cancer,time of initial recurrence,irregular perfusion,types of bladder perfusion drugs,perfusion cycles,etc.3.GroupingIn this study,were grouped patients with UTUC were given age,sex,long-term smoking,whether to take a representative Chinese medicine containing aristolochic acid(Pai Shi granule、Platoon stone soup、bolus of gentian for purging liver-fire),lymph node metastasis,previous history of bladder cancer,tumor location(kidney cancer / ureteral cancer),single tumor / Multiple,tumor diameter size,tumor stage,grading,preoperative ureteroscopy,surgical methods,postoperative regular bladder infusion drugs,etc.Result:1.Survival rate of UTUC patientsThe overall survival rates of 439 patients with UTUC were 1,3 and 5 years,which were 90%(395/439),76.4%(335/439)and 67.7%(297/439)respectively.The5 year survival rates of T1,T2,T3 and T4 UTUC patients were 92%,78%,43.8%,18.9%,respectively.There was a statistically significant difference in the survival rate between patients with stage T1-T2 and T3-T4.(p<0.05).2.Analysis of risk factors for postoperative prognosis in patients with UTUCCOX multivariate analysis showed that the risk factors affecting the long-term survival rate of UTUC patients were tumor stage,grade,tumor diameter,age,lymph node metastasis,previous history of bladder cancer,long-term smoking,and taking typical Chinese medicines containing aristolochic acid(Pai Shi granule、Platoon stone soup、bolus of gentian for purging liver-fire).3.Analysis of risk factors for postoperative recurrence of bladder cancer in UTUC patientsLogistic regression analysis showed that the risk factors for recurrence of bladder cancer were tumor stage,previous history of bladder cancer,tumor location(lower ureteral carcinoma),preoperative ureteroscopy,and periodic bladder chemotherapy drug infusion Conclusion1.early stage UTUC patients have better tumor specific survival than those with advanced stage.Early detection and early treatment can improve the survival rate of UTUC patients,so that patients can benefit from it.2.Smoking,traditional Taking representative Chinese medicines containing aristolochic acid(Pai Shi granule、Platoon stone soup、bolus of gentian for purging liver-fire),lymph node metastasis,tumor stage,grade,history of bladder cancer,older age and larger diameter tumor were risk factors for survival of UTUC patients.3.Advanced tumors,low-grade tumors(lower ureteral carcinoma)and preoperative ureteroscopy are the high risk factors for recurrence of bladder cancer in UTUC patients.Postoperative intravesical instillation can reduce the risk of recurrence of bladder cancer.