Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press46810.17650/1726-9776-2016-12-1-29-35DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. URINARY BLADDER CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак мочевого пузыряSurvival of patients with bladder cancer after radical cystectomyВыживаемость больных раком мочевого пузыря после радикальной цистэктомииKomyakovB. K.КомяковБ. К.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

кафедра урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

komyakovbk@mail.ruGulievB. G.ГулиевБ. Г.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

д.м.н., профессор кафедры урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

gulievbg@mail.ruSergeevA. V.СергеевА. В.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

д.м.н., доцент кафедры урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

urolsergeev@ya.ruFadeevV. A.ФадеевВ. А.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

д.м.н., профессор кафедры урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

UlyanovA. Yu.УльяновА. Ю.
Russian Federation

Department of Urology,

41, Kirochnaya St., Saint Petersburg 191015

кафедра урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

SavashinskyYa. S.СавашинскийЯ. С.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

аспирант кафедры урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

KasyanenkoS. S.КасьяненкоС. С.
Russian Federation

Department of Urology, 

41, Kirochnaya St., Saint Petersburg 191015

аспирант кафедры урологии,

191015, Санкт-Петербург, ул. Кирочная, 41

I.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaГБОУ ВПО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России3003201612129351207201530012016https://oncourology.abvpress.ru/oncur/article/view/468

Objective: to investigate survival in patients with bladder cancer (BC) after radical cystectomy (RCE).

Subjects and methods. Our clinic performed RCE using different urine derivations in 375 patients with BC. There were 324 (86.4%) men and 51 (13.6%) women. All the patients underwent clinical, laboratory, ultrasound, X-ray, and radiation studies.

Results. The 10-year overall and cancer-specific survival rates were 43.4 and 47.2%, respectively. In patients without regional lymph node (LN) metastases, the 2- and 3-year overall survival rates were 81.2 and 67.2%. In those with regional LN metastases, the 2- and 5-year overall survival rates were 46.9 and 13.9%. In the negative LN group, the 2- and 5-year cancer-specific survival rates were 83.6% and 70.7%, respectively. In the positive LN group, these were 51.0 and 15.1%. The overall and cancer-specific survival rates also declined with higher tumor stage and grade.

Conclusion. Tumor stage, regional LN metastases, and histopathological grade have a considerable independent impact on the overall and cancer-specific survival rates of patients with BC following RCE.

Цель исследования – изучение выживаемости больных раком мочевого пузыря (РМП) после радикальной цистэктомии (РЦЭ).

Материалы и методы. В нашей клинике 375 больным РМП выполнена РЦЭ с применением различных методов деривации мочи. Все больные – 324 (86,4 %) мужчины и 51 (13,6 %) женщина – прошли клинико-лабораторное, ультразвуковое, рентгенологическое, лучевое обследование.

Результаты. Общая выживаемость при 10-летнем катамнестическом периоде наблюдения составила 43,4 %, а 10-летняя раковоспецифическая выживаемость – 47,2 %. У больных без метастазов в регионарные лимфатические узлы (ЛУ) 2-летняя общая выживаемость составила 81,2 %, 3-летняя – 67,2 %. В группе пациентов с метастазами в регионарные ЛУ общая 2-летняя выживаемость составила 46,9 %, 5-летняя – 13,9 %. В лимфоотрицательной группе 2-летняя раковоспецифическая выживаемость составила 83,6 %, 5-летняя – 70,7 %. В лимфоположительной группе 2-летняя раковоспецифическая выживаемость составила 51,0 %, 5-летняя – 15,1 %. По мере увеличения стадии pT и степени гистопатологической градации опухоли общая и раковоспецифическая выживаемость соответственно снижались.

Заключение. Стадия опухоли (pT), статус регионарных ЛУ (pN), степень гистопатологической градации (pG) оказывают существенное независимое влияние на общую и раковоспецифическую выживаемость у больных РМП после РЦЭ.

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