Effect of the number of negative lymph nodes on prognosis of patients with muscle-invasive bladder cancer
Objective:To investigate the effect of the number of negative lymph nodes on the prognosis of pa-tients with muscle-invasive bladder cancer(MIBC).Methods:The clinicopathological data of 73 MIBC patients who were admitted to the Dongnan Hospital of Xiamen University and underwent radical cystectomy from January 2015 to June 2020 were retrospectively analyzed.The patients were divided into poor prognosis group(n=32)and good prognosis group(n=41)according to whether tumor recurrence or death occurred after surgery.The total number of negative lymph nodes was calculated according to postoperative pathological results,then the ROC curve was drawn to analyze the predictive effect of negative lymph nodes on prognosis.Univariate and logistic mul-tivariate analysis were used to analyze prognostic factors in MIBC patients.The effects of the number of negative lymph nodes on recurrence free survival(RFS)and overall survival(OS)were analyzed by Kaplan-Meier risk curve.Results:Among the 73 patients with MIBC,32 cases had tumor recurrence,and the recurrence rate was 43.84％.The recurrence time was 4-35 months,with an average of 22.72 months.Twenty-five cases died,and the mortality rate was 34.25％.The death time was 8-36(mean 25.68)months.Univariate analysis showed that the maximum length of tumor ≥ 3 cm,clinical stage Ⅲ-Ⅳ,lymph node metastasis,the number of lymph nodes dissected＜23,the number of negative lymph nodes＜18 were associated with poor prognosis of MIBC(P＜0.05).Multivariate analysis showed that the maximum length and diameter of the tumor ≥3 cm(OR=9.125,95％CI:1.987-14.371),clinical stage Ⅲ-Ⅳ(OR=8.377,95％CI:1.965-12.752),the number of lymph nodes dissected＜23(OR=16.346,95％CI:5.081-28.646),the number of negative lymph nodes＜18(OR=22.043,95％CI:5.625-44.245)were independent risk factors in poor prognosis of MIBC.Kaplan-Meier analy-sis showed that RFS of patients with negative lymph nodes＜18 were shorter than that of patients with negative lymph nodes ≥18(x2=37.610,P＜0.001),and OS of patients with negative lymph nodes＜18 was shorter than that of patients with negative lymph nodes≥18(x2=26.690,P＜0.001).Conclusion:The number of nega-tive lymph nodes less than 18 is a risk factor in poor prognosis in patients with MIBC,which has predictive value for patients'prognosis and can be used as an indicator for clinical prognosis evaluation.
number of negative lymph nodesbladder cancerlymph nodesradical cystectomyprognosisrecurrence
NETL
NSTL
万方数据
