首页膀胱肿瘤病因/危险因素证据详情

Air pollution exposure and bladder, kidney and urinary tract cancer risk: A systematic review

原文: 2020 年 发布于 World J Urol 23 卷 第 4 期 971-984 浏览量:232次

作者: Sakhvidi M. J. Z. Lequy E. Goldberg M. Jacquemin B.

作者单位: Department of Urology, Freeman Hospital, Newcastle, UK. Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle, UK.

归属分类: 膀胱肿瘤病因/危险因素证据

DOI: 10.1186/s12889-022-12516-2

关键词: Bladder cancer Coffee Cohort studies Meta-analysis

文献简介

Background: T1, high-grade, nonmuscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate and progression to muscle-invasive disease concerns a significant number of patients. To overcome limitations of initial transurethral resection of bladder tumor (TURBT), various strategies are proposed in the literature. One of them is performance of restaging TURBT (re-TURBT). In recent years, it has been shown that re-TURBT can provide valuable additional pathologic information. However, its potential effect on survival improvement is debatable and benefits from this procedure have been suggested to be dependent on several clinicopathological factors (e.g., the presence of detrusor muscle in initial TURBT). Evidence Acquisition: A systematic search was conducted within the three electronic databases, including Medline, Scopus, and Embase. The following outcomes were retrieved: outcome measurements of recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS), including hazard ratios and 95% confidence intervals. Initially, a main analysis for each outcome (RFS, PFS, CSS, and OS) was performed. Subsequently, we conducted subgroup analyses for the following factors: T1 grade, presence of detrusor muscle in initial TURBT, and type of adjuvant intravesical therapy. Evidence Synthesis: Finally, six studies with overall 3257 participants were identified for this meta-analysis. A significant impact of re-TURBT on RFS, PFS, CSS, and OS was not found in the overall analysis that included all patients with T1 bladder tumors. On the other hand, subgroup analyses, including studies reporting cohorts with mixed T1 tumor grading, revealed that re-TURBT was associated with significantly better RFS, PFS, and OS. Conclusions: This meta-analysis shows that re-TURBT does not improve survival outcomes in patients with T1 tumors; however, results of some particular subgroup analyses indicate its potential positive impact on the subsequent course of the disease. Furthermore, high-quality, prospective, randomized controlled trials are necessary to make a final statement about the therapeutic role of re-TURBT in T1 NMIBC.

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