■观察铜绿假单胞菌甘露糖敏感血凝素(PA-MSHA)对根治性膀胱切除术(RC)患者预后和淋巴漏发生率的影响。
■本研究纳入2013-2022年在兰州大学第二医院行RC的129例患者。将他们分为43例接受PA-MSHA治疗的患者和86例对照组。应用治疗加权的逆概率(IPTW)来减少潜在的选择偏差。采用Kaplan-Meier法和Cox回归分析PA-MSHA对患者生存率及术后淋巴漏发生率的影响。
■与对照组相比,PA-MSHA组表现出改善的总体生存率(OS)和癌症特异性生存率(CSS)。PA-MSHA组的3年和5年总生存率(OS)分别为69.1%和53.2%,分别,对照组分别为55.6%和45.3%(Log-rank=3.218,P=0.072)。PA-MSHA组的3年和5年癌症特异性生存率(CSS)分别为73.3%和56.5%,分别,对照组分别为58.0%和47.3%(Log-rank=3.218,P=0.072)。此外,PA-MSHA组的3年和5年无进展生存率(PFS)分别为74.4%和56.8%,分别,对照组分别为57.1%和52.2%(Log-rank=2.016,P=0.156)。多因素Cox回归分析提示淋巴结转移和远处转移是患者预后不良的因素,而使用PA-MSHA可以改善患者的OS(HR:0.547,95CI:0.304-0.983,P=0.044),PFS(HR:0.469,95CI:0.229-0.959,P=0.038)和CSS(HR:0.484,95CI:0.257-0.908,P=0.024)。在IPTW调整后的队列中观察到相同的趋势。尽管术后淋巴漏的发生率没有显着差异[18.6%(8/35)与15.1%(84.9%),P=0.613]和盆腔引流量[470(440)mlvs.462.5(430)ml,P=0.814]PA-MSHA组与对照组,PA-MSHA可缩短引流管的中位保留时间(7.0dvs9.0d)(P=0.021)。
■PA-MSHA可以改善OS患者的根治性膀胱切除术,PFS,CSS,缩短盆腔引流管留置时间。
UNASSIGNED: To observe the effect of Pseudomonas aeruginosa mannose-sensitive hemagglutinin (PA-MSHA) on the prognosis and the incidence of lymphatic leakage in patients undergoing radical cystectomy (RC).
UNASSIGNED: A total of 129 patients who underwent RC in Lanzhou University Second Hospital from 2013 to 2022 were enrolled in this study. They were divided into 43 patients treated with PA-MSHA and 86 patients in the control group. Inverse probability of treatment weighting (IPTW) was applied to reduce potential selection bias. Kaplan-Meier method and Cox regression analysis were used to analyze the effect of PA-MSHA on the survival of patients and the incidence of postoperative lymphatic leakage.
UNASSIGNED: The PA-MSHA group exhibited improved overall survival (OS) and cancer-specific survival (CSS) rates compared to the control group. The 3-year and 5-year overall survival (OS) rates for the PA-MSHA group were 69.1% and 53.2%, respectively, compared to 55.6% and 45.3% for the control group (Log-rank=3.218, P=0.072). The 3-year and 5-year cancer-specific survival (CSS) rates for the PA-MSHA group were 73.3% and 56.5%, respectively, compared to 58.0% and 47.3% for the control group (Log-rank=3.218, P=0.072). Additionally, the 3-year and 5-year progression-free survival (PFS) rates for the PA-MSHA group were 74.4% and 56.8%, respectively, compared to 57.1% and 52.2% for the control group (Log-rank=2.016, P=0.156). Multivariate Cox regression analysis indicates that lymph node metastasis and distant metastasis are poor prognostic factors for patients, while the use of PA-MSHA can improve patients\' OS (HR: 0.547, 95%CI: 0.304-0.983, P=0.044), PFS (HR: 0.469, 95%CI: 0.229-0.959, P=0.038) and CSS (HR: 0.484, 95%CI: 0.257-0.908, P=0.024). The same trend was observed in the cohort After IPTW adjustment. Although there was no significant difference in the incidence of postoperative lymphatic leakage [18.6% (8/35) vs. 15.1% (84.9%), P=0.613] and pelvic drainage volume [470 (440) ml vs. 462.5 (430) ml, P=0.814] between PA-MSHA group and control group, PA-MSHA could shorten the median retention time of drainage tube (7.0 d vs 9.0 d) (P=0.021).
UNASSIGNED: PA-MSHA may improve radical cystectomy in patients with OS, PFS, and CSS, shorten the pelvic drainage tube retention time.