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目的:探讨根治性膀胱全切术后患者临床病理及预后的性别差异。方法:回顾性分析427例根治性膀胱全切患者的临床病理资料并行院外随访,通过单因素分析,比较膀胱癌临床及病理特点的性别差异,通过Kaplan-Meier生存分析法及单因素、多因素Cox回归分析,探讨膀胱癌长期预后的差异。结果:本组男361例,女66例,男女发病人数之比约为5.5∶1。入组患者中,男性吸烟比例更高(P<0.001),女性化学物品接触比例更高(P=0.018)。与男性相比,女性患者更易出现较低的肿瘤分期(P=0.003);手术过程中,女性患者较男性出血少(P=0.018),手术时间短(P=0.005),更倾向选择非可控的尿流改道方式(P<0.001)。Kaplan-Meier生存分析显示两组整体总生存率(P=0.894)、肿瘤特异性生存率差异(P=0.735)无统计学意义。结论:女性膀胱全切术后膀胱癌患者更易出现较低的肿瘤分期,倾向选择非可控的尿流改道方式,但患者整体长期预后无显著性别差异。
Objective: To investigate the gender differences of clinicopathological features and prognosis of radical cystectomy patients. Methods: The clinical and pathological data of 427 patients undergoing radical cystectomy were retrospectively analyzed. One-factor analysis was used to compare the clinical and pathological features of bladder cancer. Kaplan-Meier survival analysis and single factor and multiple factor Cox regression analysis to explore the long-term prognosis of bladder cancer. Results: There were 361 males and 66 females in this group, with a ratio of men to women of about 5.5: 1. Among the enrolled patients, men had a higher proportion of smoking (P <0.001) and female chemical exposure (P = 0.018). Compared with men, female patients were more likely to have lower tumor stage (P = 0.003). Female patients had less bleeding (P = 0.018) and shorter operation time (P = 0.005) Controlled urinary diversion (P <0.001). Kaplan-Meier survival analysis showed that the overall overall survival (P = 0.894), tumor-specific survival difference (P = 0.735) was not statistically significant. Conclusions: Patients with bladder cancer after total bladder resection are more likely to have lower tumor staging and tend to choose uncontrolled urinary diversion. However, there is no significant gender difference in overall long-term prognosis of patients.