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Abstract：
BACKGROUND: The safety and efficacy of CRS + HIPEC combined with urinary tract resection and reconstruction are controversial. This study aims to summarize the clinicopathological features and to evaluate the safety and survival prognosis of CRS + HIPEC combined with urinary tract resection and reconstruction.
METHODS: The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison.
RESULTS: Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1-76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively).
CONCLUSIONS: The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation.
METHODS: The patients who underwent urinary tract resection and reconstruction as part of CRS surgery were retrospectively selected from our disease-specific database for analysis. The clinicopathological characteristics, treatment-related variables, perioperative adverse events (AEs), and survival outcomes were studied using a descriptive approach and the K-M analysis with log-rank comparison.
RESULTS: Forty-nine patients were enrolled. Perioperative serious AEs (SAEs) were observed in 11 patients (22.4%), with urinary SAEs occurring in 3 patients (6.1%). Additionally, there were 23 cases (46.8%) involving urinary adverse events (UAEs). The median overall survival (OS) in the entire cohort was 59.2 (95%CI: 42.1-76.4) months. The median OS of the UAE group and No-UAE group were 59.2 months (95%CI not reached), and 50.5 (95%CI: 11.5 to 89.6) months, respectively, with no significant difference (P = 0.475). Furthermore, there were no significant differences in OS based on the grade of UAEs or the number of UAEs (P = 0.562 and P = 0.622, respectively).
CONCLUSIONS: The combination of CRS + HIPEC with urinary tract resection and reconstruction is associated with a high incidence of Grade I-II UAEs, which do not have an impact on OS. The safety profile of this combined technique is acceptable. However, this is a retrospective single-center single-arm analysis, with limitations of generalizability and potential selection bias. The findings need high-level validation.
摘要：
背景：CRS+HIPEC联合泌尿道切除和重建的安全性和有效性存在争议。本研究旨在总结CRS+HIPEC联合泌尿道切除重建的临床病理特征,评价其安全性和生存预后。
方法：从我们的疾病特异性数据库中回顾性选择作为CRS手术一部分而接受尿路切除和重建的患者进行分析。临床病理特征，治疗相关变量，围手术期不良事件（AE），使用描述性方法和对数秩比较的K-M分析研究了生存结局。
结果：纳入49例患者。11例(22.4%)患者围手术期出现严重不良事件(SAEs),3例患者发生尿SAE（6.1%）。此外,有23例（46.8％）涉及尿液不良事件（UAE）。整个队列的中位总生存期（OS）为59.2（95CI：42.1-76.4）个月。UAE组和No-UAE组的中位OS为59.2个月（未达到95CI），和50.5（95CI：11.5至89.6）个月，分别,差异无统计学意义(P=0.475)。此外，根据UAE的等级或UAE的数量，OS没有显着差异（分别为P=0.562和P=0.622）。
结论：CRS+HIPEC与尿路切除和重建的组合与I-II级UAE的高发生率相关，对操作系统没有影响。这种组合技术的安全性是可以接受的。然而,这是一个回顾性的单中心单臂分析，具有普适性和潜在选择偏差的局限性。这些发现需要高级验证。
方法：从我们的疾病特异性数据库中回顾性选择作为CRS手术一部分而接受尿路切除和重建的患者进行分析。临床病理特征，治疗相关变量，围手术期不良事件（AE），使用描述性方法和对数秩比较的K-M分析研究了生存结局。
结果：纳入49例患者。11例(22.4%)患者围手术期出现严重不良事件(SAEs),3例患者发生尿SAE（6.1%）。此外,有23例（46.8％）涉及尿液不良事件（UAE）。整个队列的中位总生存期（OS）为59.2（95CI：42.1-76.4）个月。UAE组和No-UAE组的中位OS为59.2个月（未达到95CI），和50.5（95CI：11.5至89.6）个月，分别,差异无统计学意义(P=0.475)。此外，根据UAE的等级或UAE的数量，OS没有显着差异（分别为P=0.562和P=0.622）。
结论：CRS+HIPEC与尿路切除和重建的组合与I-II级UAE的高发生率相关，对操作系统没有影响。这种组合技术的安全性是可以接受的。然而,这是一个回顾性的单中心单臂分析，具有普适性和潜在选择偏差的局限性。这些发现需要高级验证。
