文章：

上尿路低级别尿路上皮肿瘤的局部内镜治疗——连续单中心118例患者的肿瘤学结果分析

Local Endoscopic Treatment of Low-Grade Urothelial Tumors in the Upper Urinary Tract—Oncological Outcome of a Consecutive Single-Center Series of 118 Patients

原文发布日期：11 November 2024

DOI: 10.3390/cancers16223795

类型: Article

开放获取: 是

英文摘要：

Background: Upper urinary tract urothelial tumors are mostly treated with the use of endoscopic laser ablation. The treatment is recommended when the tumor is low grade and non-invasive. Objective: The aim of the present study was to investigate the oncological outcome of patients treated endoscopically for low-grade (LG) upper tract urothelial carcinoma (UTUC). Methods: One hundred and eighteen consecutive patients with pTa LG UTUC initially treated with laser ablation from 2012–2022 at a single university hospital were included. Patient and tumor characteristics, treatment, and oncological outcomes were retrospectively registered from electronic medical journals. Survival analysis was performed using Kaplan–Meier and Nelson–Aalen plots. Results: The median number of local recurrences was 2 with a median time to first recurrence of 5 months (IQR: 2–46). The 2-year share of patients having no recurrence was 28.8%. The risk of recurrence was highest within the first 3 years following initial treatment. Two-year survival function with no progression and preserved renal unit was 67.9%. The two-year overall survival (OS) and disease-specific survival (DSS) were 84.2% and 97.1%. The 5-year OS and DSS were 59.1% and 94.1%. The median follow-up time for OS was 36 months (IQR: 20.3–58.8). Conclusions: In the patient series, we found that the risk of recurrence following laser ablation of LG UTUC was high; however, it was associated with a low risk of progression and high OS and DSS. Therefore, we conclude that treatment with laser ablation in patients with LG UTUC is safe, although frequent follow-up is needed to detect recurrence.

摘要翻译： 

背景：上尿路尿路上皮肿瘤多采用内镜下激光消融术治疗。该疗法适用于低级别、非浸润性肿瘤。本研究旨在探讨内镜下治疗低级别上尿路尿路上皮癌患者的肿瘤学结局。 方法：纳入2012年至2022年间在某大学医院连续收治的118例初诊为pTa低级别上尿路尿路上皮癌并接受激光消融治疗的患者。通过电子病历系统回顾性记录患者及肿瘤特征、治疗方案与肿瘤学结局。采用Kaplan-Meier法和Nelson-Aalen曲线进行生存分析。 结果：患者局部复发中位次数为2次，首次复发中位时间为5个月（四分位距：2-46个月）。术后2年无复发患者比例为28.8%，复发风险在初始治疗后3年内最高。2年无进展且保留肾单位生存率为67.9%，2年总生存率和疾病特异性生存率分别为84.2%和97.1%，5年总生存率和疾病特异性生存率分别为59.1%和94.1%。总生存期的中位随访时间为36个月（四分位距：20.3-58.8个月）。 结论：本系列研究显示，低级别上尿路尿路上皮癌激光消融术后复发风险较高，但疾病进展风险较低，且总生存率和疾病特异性生存率良好。因此我们认为，低级别上尿路尿路上皮癌的激光消融治疗是安全的，但需通过密切随访监测复发情况。

原文链接：

Local Endoscopic Treatment of Low-Grade Urothelial Tumors in the Upper Urinary Tract—Oncological Outcome of a Consecutive Single-Center Series of 118 Patients