Background/Objectives:The aim of this study is to assess the prognostic implications of metastatic anatomical location in patients with recurrent bladder cancer (BC) after cystectomy.Methods:The study is a retrospective cohort study. All data were collected from a clinical database from Aarhus University Hospital. Kaplan–Meier curves were used to analyse survival probabilities. Crude and adjusted Cox regression was used to calculate the hazard ratios (HRs) for overall mortality between different locations of metastases and the number of metastases.Results:In total, 180/664 (27.1%) patients who underwent radical cystectomy as a treatment of BC in the time period from 2015 to 2021 ultimately developed recurrent disease. The median follow-up period was 433 days (Q1: 256, Q3; 847). In a crude analysis for overall mortality, patients with both lymph node and distant organ metastasis had a worse prognosis than patients with lymph node metastasis only (HR = 2.25 (95% CI: 1.36–3.75,p= 0.002)). In the adjusted analysis, patients with ≥2 metastatic sites had higher hazard than patients with only a single site of recurrence (HR = 1.63 (95% CI: 1.15–2.33,p= 0.01)). Patients with organ metastasis had higher hazard ratios than patients with lymph node metastases and local recurrence only (HR = 1.74 (95% CI: 1.07–2.84,p= 0.026)). When analysing patients with single metastasis, there was a statistically significant difference in overall survival probability in the following groups: lymph node metastasis, other organ metastases, bone metastasis (p= 0.04).Conclusions:This study shows potentially clinically relevant associations between the anatomical location of metastases and patients’ prognosis. Furthermore, we were able to demonstrate an association between a higher number of metastatic sites and a worse prognosis.
背景/目的：本研究旨在评估膀胱癌根治术后复发患者转移灶解剖位置对预后的影响。方法：本研究为回顾性队列研究，所有数据均来源于奥胡斯大学医院临床数据库。采用Kaplan-Meier曲线分析生存概率，通过未校正及校正的Cox回归模型计算不同转移部位及转移灶数量对总死亡风险比（HR）。结果：2015年至2021年间接受根治性膀胱切除术的664例患者中，共有180例（27.1%）最终出现疾病复发。中位随访时间为433天（Q1：256天，Q3：847天）。在总死亡率的未校正分析中，同时存在淋巴结和远处器官转移的患者预后较仅淋巴结转移者更差（HR=2.25，95% CI：1.36-3.75，p=0.002）。校正分析显示，≥2个转移部位患者的死亡风险高于单部位复发患者（HR=1.63，95% CI：1.15-2.33，p=0.01）。器官转移患者的风险比高于仅淋巴结转移及局部复发患者（HR=1.74，95% CI：1.07-2.84，p=0.026）。在单发转移患者亚组分析中，淋巴结转移、其他器官转移及骨转移三组间的总生存概率存在统计学显著差异（p=0.04）。结论：本研究揭示了转移灶解剖位置与患者预后之间存在具有潜在临床意义的关联，同时证实转移部位数量增加与不良预后相关。
肿瘤(癌症)患者之家