| Summary: | 碩士 === 嘉南藥理大學 === 醫務管理系 === 106 === Background and motivation: Bladder cancer is a common urinary tract cancer in Taiwan. There are special carcinogenic factors such as kidney dialysis, black foot disease, etc. although the mortality rate of bladder cancer is not very high. The incidence rate of bladder cancer is high, so the diagnosis and treatment can not be ignored on modern medicine and public health issues.
Objectives: The purpose of this study was to investigate the prognosis factors of postoperative survival and the risk factors of death in bladder cancer patients. The results could be a reference for medical treatment and improving the medical quality of cancer treatment.
Methods: The source of data is a total of 748 postoperative patients with newly diagnosed bladder cancer from 2010 to 2015 at a medical center in the south Taiwan. The descriptive statistics were used to present patient demographic characteristics, cancer confirmation, TNM stage, pathological test results, and the distribution of treatment methods. The inferential statistical methods include the Chi-square test, the Kaplan-Meier method, the Log-rank test, and the Cox regression model to investigate the predictors of survival prognosis of bladder cancer and the risk factors of death. This study uses Microsoft Excel 2016 and SPSS 22.0 to organize and analyze data.
Results: In the study sample, we got men accounted for 68.4%. The first transurethral resection of the bladder tumors was at most those were above 65 years old (60.4%). The most people were not smoking (77.1%), 98.5% of patients not received kidney transplants, and 80.5 %, 88.5% of patients not having end-stage renal disease, upper urinary tract urothelial carcinoma. The Cox forward stepwise regression model was used for analysis of the relative importance of the prognostic predictors of postoperative survival in patients with bladder cancer. The age of bladder tumor resection, hemoglobin, neutrophils, creatinine acid, and cancer stage, etc. were the significant risk factors of the mortality rate of patient.
Conclusions: This study was to investigate the prognostic factors of bladder cancer. In univariate analysis found the overall morbidity in patients age, end stage renal disease, white blood cells, hemoglobin, neutrophil (seg), lymphocyte, platelets, creatinine, the degree of tumor invasion, lymph node metastasis, whether distant organs metastasis, cancer of stage, histological grade, whether the muscle layer is invaded and treatment modalities such as 15 independent are predictors factors of survival time in patients with bladder cancer prognosis. Also found that the age of morbidity in the multivariate analysis, hemoglobin, neutrophil (seg), creatinine and postoperative cancer of the other as the most important survival time prognostic factors. Based on the results of this study, the following specific recommendations are made: 1.To strengthen the attention to early screening for bladder cancer, with early detection and early treatment, thereby the reducing the risk of death and improving survival are possible. 2. The routine use of biochemical test items, including hemoglobin, neutrophil (Seg), creatinine testing, may assist in the evaluation of bladder cancer, and be an important reference for clinical decision making. 3. The prognosis of surgical resection and chemotherapy for bladder cancer patients is better than that of only surgical resection. Clinicians should evaluate the predictors of survival prognosis and provide personalized medicine to improve the medical quality of cancer treatment.
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