vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"vestim-334Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEБЕЗРЕЦИДИВНАЯ ВЫЖИВАЕМОСТЬ ПРИ РАКЕ МОЧЕВОГО ПУЗЫРЯ БЕЗ МЫШЕЧНОЙ ИНВАЗИИRECURRENCE-FREE SURVIVAL IN PATIENTS WITH NON-MUSCLE BLADDER CANCERРолевичА. И.RolevichA. I.

вед. науч. сотрудник лаборатории онкоурологической патологии хирургического отдела

Leading Research of the Laboratory of Oncourology, Department of Surgery

alexander.rolevich@gmail.comРеспубликанский научно-практический центр онкологии и медицинской радиологии им. Н. Н. АлександроваN. N. Alexandrov National Cancer Centre201613012017044456Copyright © Ролевич А.И., 20172017Ролевич А.И.Rolevich A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/334

Роль ряда терапевтических воздействий при раке мочевого пузыря без мышечной инвазии (РМПБМИ) четко не определена. С учетом гетерогенности РМПБМИ по прогнозу и возможной связи эффективности терапии с риском рецидива  целесообразно изучать указанную эффективность в определенных прогностических стратах. Целью работы стала оценка влияния различных терапевтических  воздействий на безрецидивную выживаемость пациентов, страдающих РМПБМИ, в различных прогностических группах.Ретроспективно проанализированы результаты лечения пациентов с РМПБМИ (п  =   921), которые были разделены на 4 группы риска рецидива. Безрецидивную выживаемость вычисляли по методу Каплана–Мейера, статистическую значимость различий оценивали с помощью log-rank теста.Медиана наблюдения составила 61 мес. Выполнение фотодинамической диагностики совместно с трансуретральной резекцией (ТУР) приводило к существенному улучшению безрецидивной выживаемости в группах высокого и крайне высокого риска. Преимущество от выполнения ТУР опытным хирургом и иммунотерапии вакциной бациллы Кальметта–Герена (БЦЖ) отмечалось в группах промежуточного, высокого и крайне высокого риска. Одно-кратная инстилляция доксорубицина и ранняя повторная ТУР существенно не влияли на безрецидивную выживаемость ни в одной прогностической страте.На основании стратифицированного анализа эффективности различных воздействий определены показания к выполнению ТУР хирургом с большим опытом проведения операций, адъювантной иммунотерапии БЦЖ и фотодинамической диагностики при РМПБМИ.

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