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Analysis of the Risk Factors of Post-operative One Year Recurrence of Bladder Tumor

Author: XuHang
Tutor: WangYuJie
School: Xinjiang Medical University
Course: Surgery
Keywords: post-operative of Bladder tumor recurrence risk factor unconditioned Logistic regression analysis
CLC: R737.14
Type: Master's thesis
Year: 2008
Downloads: 142
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Abstract


Objective: Bladder tumor is the 8th most common malignant tumor in China, the 5th in Europe, and 4th in the USA. 80% of Bladder cancer is limited under the mucous membrane of Bladder; meanwhile 20% of the muscular layer is aggressed by the cancer cell. The treatment and the prognosis of these two types of cancer are totally different; the malignancy of aggressive bladder carcinoma is more advanced comparing to superficial bladder carcinoma. If the patients do not receive further treatment after the radical surgery, there is about 70% of the recurrence, 35% of the superficial bladder carcinoma will emerge with more advanced malignancy. To increase the curative effect of surgery and reduce the recurrence, we studied on the risk factors of post-operative one year recurrence of Bladder tumor, and their role, analyzed the intervention and measurements.Methods: The unconditioned Logistic regression analysis was undergone on patients who received post-operative one year follow-up. Combined with clinical experience and pertinent literature, we chose 11 risk factors that might be relative to the recurrence of Bladder tumor. The unifactor model was undertaken on 11 risk factors we chose at first and then the multifactor Logistic regression analysis was undertaken for parametric estimation and hypothesis testing, the regression coefficient, P value, OR estimation value and 95% CI were analyzed for selecting the risk factors that influence the post-operative recurrence. From June 1st 2006 to May 31st 2007, 203 patients who received surgical resection in Xinjiang Medical University first affiliated hospital were undertaken one year of post-operative follow-up till May 31st 2008.Results: During the one year of follow-up, there were 89 cases of recurrence, 46 cases loss of follow-up. The OR value of bladder tumor staging is 1.547 (P=0.009;95%CI 1.115~2.144)?the classification is 2.488 (P=0.001;95%CI 1.482~4.177),the surgical methods type-2(radical surgery)is 0.062 (P=0.002;95%CI 0.010~0.370)?the adjacent radiation-chemo-therapy is 0.156 (P=0.000;95%CI 0.057~0.431)?the bladder perfusion is 0.120(P=0.000;95%CI 0.042~0.342) respectively.Conclusion: Our study shows that, the cancer staging and classification are the risk factor of post-operative recurrence of Bladder tumor, however surgical methods type-2(radical surgery),adjacent radiation-chemo-therapy , bladder perfusion are the protection factors of post-operative Bladder tumor which indicates the more advance is the tumor staging and classification the higher is the post-operative recurrence. And radical surgery, combined treatment like adjacent radiation-chemo-therapy and bladder perfusion decrease the post-operative recurrence.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Urinary tumors > Bladder tumor
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