Objective: To assess the survival outcomes of patients diagnosed with muscle-invasive bladder cancer (MIBC) who are not candidates for curative treatment and to identify the factors influencing these outcomes. Methods: We conducted an analysis of patients diagnosed with MIBC who were either unable or unwilling to undergo curative therapy. We evaluated overall survival (OS) and cancer-specific survival (CSS) and examined their associations with various clinical variables. Additionally, we assessed emergency department visits and palliative procedures. Results: The study included 142 patients with a median age of 79.4 years and a Charlson Comorbidity Index of 9.8. At diagnosis, 59.2% of the patients had localized disease, 23.2% had metastatic disease, and 49.3% presented with hydronephrosis. Curative treatment was excluded due to comorbidities in 40.1% of cases and advanced disease stage in 36.6%. The 1-year and 2-year OS rates were 42.8% and 23.6%, respectively, with a median survival of 10.6 months. The 1-year and 2-year CSS rates were 49.6% and 30.2%, respectively, with a median survival of 11.9 months. Worse survival outcomes were associated with advanced disease stage and the presence of hydronephrosis. Patients excluded from curative treatment solely due to age had a relatively better prognosis. On average, patients visited the emergency department three times: 19% underwent palliative transurethral resection of the bladder tumor, 14.8% received radiotherapy to control hematuria, and nephrostomy tubes were placed in 26.1% of cases. Conclusions: Patients with MIBC who are unable or unwilling to undergo curative treatment have a median overall survival of less than one year, with worse outcomes observed in those with advanced disease stage and hydronephrosis.
目的：评估不适合接受根治性治疗的肌层浸润性膀胱癌（MIBC）患者的生存结局，并分析其影响因素。方法：对确诊为MIBC且无法或不愿接受根治性治疗的患者进行回顾性分析。评估总生存期（OS）和癌症特异性生存期（CSS），并分析其与各项临床变量的相关性。同时统计急诊就诊情况及姑息性治疗措施。结果：研究共纳入142例患者，中位年龄79.4岁，查尔森合并症指数为9.8。确诊时59.2%为局限性病变，23.2%存在转移病灶，49.3%伴有肾积水。40.1%因合并症、36.6%因疾病晚期状态被排除在根治性治疗之外。1年及2年OS率分别为42.8%和23.6%，中位生存期10.6个月；1年及2年CSS率分别为49.6%和30.2%，中位生存期11.9个月。晚期疾病分期及肾积水与不良生存结局显著相关。仅因年龄因素排除根治治疗的患者预后相对较好。患者平均急诊就诊3次，其中19%接受姑息性经尿道膀胱肿瘤切除术，14.8%为控制血尿接受放疗，26.1%行肾造瘘术。结论：无法或不愿接受根治性治疗的MIBC患者中位总生存期不足一年，疾病晚期及伴有肾积水者预后更差。
肿瘤(癌症)患者之家