urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2017-5-1-12-19urovest-119Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОНКОЛОГИЧЕСКИЕ РЕЗУЛЬТАТЫ ПЕРВИЧНОЙ, СПАСИТЕЛЬНОЙ И ПАЛЛИАТИВНОЙ ЦИСТЭКТОМИИ ПРИ РАКЕ МОЧЕВОГО ПУЗЫРЯONCOLOGICAL RESULTS OF PRIMARY, SALVAGE AND PALLIATIVE CISTECTOMY OF BLADDER CANCERВасильевО. Н.Vasil’evO. N.vasilyev_on@mail.ruКоганМ. И.KoganM. I.dept_kogan@mail.ruПерепечайВ. А.PerepechayV. A.

Перепечай Вадим Анатольевич, доктор медицинских наук, руководитель центра урологии, нефрологии, диализа и пересадки почки Ростовской клинической больницы ФГБУЗ «Южный окружной медицинский Центр Федерального медико-биологического агентства России».

perepechay_va@mail.ruРостовский государственный медицинский университетРоссияRostov State Medical UniversityRussian FederationРостовская клиническая больницаРоссияRostov Clinical Hospital of the Southern Federal District Medical CenterRussian Federation201730032017511219Copyright © Васильев О.Н., Коган М.И., Перепечай В.А., 20172017Васильев О.Н., Коган М.И., Перепечай В.А.Vasil’ev O.N., Kogan M.I., Perepechay V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/119Введение

Введение. Современные исследования показывают впечатляющее пятилетнее отсутствие тазового рецидива в 80%-90% случаев и пятилетние общую и канцерспецифическую выживаемости 59%-60% и 55%-65% соответственно для радикальной цистэктомии (РЦЭ).

Цель исследования

Цель исследования. Анализ результатов радикального и паллиативного лечения у пациентов с ра ком мочевого пузыря.

Материалы и методы

Материалы и методы. В исследование включены 349 пациентов, подвергнутых РЦЭ, из них выделены три группы: РЦЭ первичная (n=206), РЦЭ спасения (n=119) и ЦЭ паллиативная (n=24). Расчет показателей выживаемости по годам наблюдения выполняли по методике Kaplan-Meier с учетом последовательного выбывания из анализа больных.

Результаты

Результаты. Достоверно худшие показатели всех видов выживаемости выявлены при паллиативной ЦЭ. При сравнении онкологической результативности первичной и спасительной РЦЭ статистически достоверная разница в показателях выживаемости в сравниваемых группах отсутствует.

Выводы

Выводы. При наличии показаний РЦЭ должна рассматриваться не как терапия второй линии, а как первичный лечебный подход. Выполнение ранней спасительной РЦЭ при прогрессии рака мочевого пузыря на фоне органосохраняющего лечения обеспечивает онкологические результаты аналогичные таковым при первичной РЦЭ. 

Introduction

Introduction. Modern studies show an impressive 5-year absence of pelvic recurrence in 80% to 90% of cases and a 5-year overall and cancer-specific survival of 59% to 60% and 55% to 65% for radical cystectomy (RCE), respectively.

Objective

Objective. Analysis of the results of radical and palliative treatment in patients with bladder cancer.

Materials and methods

Materials and methods. The study included 349 patients exposed to RCE, of which three groups were identified: RCE primary (n = 206), salvage RCE (n = 119) and CE palliative (n = 24). Calculation of survival rates for the years of follow-up was performed according to the Kaplan-Meier method, taking into account consecutive elimination from the analysis of patients.

Results

Results. Based on the results of the performed analysis, it was established that significantly worse indices for all types of survival were revealed in palliative CE. Comparing the oncological effectiveness of primary and salvage RCE, there is no statistically significant difference in survival rates in the compared groups.

Conclusions

Conclusions. RCE should not be considered as second-line therapy, but in the presence of indications as a primary medical approach. The performance of early salvage RCE with progression of bladder cancer against the background of organ-preserving treatment provides oncological results similar to those in primary RCE. 

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The authors declare that there are no conflicts of interest present.