首页膀胱肿瘤病因/危险因素证据详情

A Systematic Review and Meta-Analysis of Clinicopathologic Factors Predicting Upper Urinary Tract Recurrence After Radical Cystectomy for Urothelial Bladder Cancer

原文: 2022 年 发布于 Journal of Clinical Oncology 2022 卷 第 5 期 95-101 浏览量:260次

作者: Kardoust Parizi M. Margulis V. Lotan Y. Aydh A. Shariat S. F.

作者单位: Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil. Hospital Israelita Albert Einstein, São Paulo, Brazil. Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil, fred.timoteo@gmail.com. Hospital Israelita Albert Einstein, São Paulo, Brazil, fred.timoteo@gmail.com. Division of Urology, Fundació Puigvert, Barcelona, Spain.

归属分类: 膀胱肿瘤病因/危险因素证据

DOI: 10.1002/bco2.206

关键词: Cystectomy/methods *Enhanced Recovery After Surgery Humans Length of Stay Meta-Analysis as Topic Postoperative Complications/surgery *Urinary Bladder Neoplasms/surgery

文献简介

International guidelines recommend repeat transurethral resection of bladder tumors (reTURB) for selected patients with high-risk non-muscle invasive bladder cancer to remove possible residual tumors, restage tumors and improve the therapeutic outcome. However, most evidence supporting the benefits of reTURB is from conventional TURB. The role of reTURB in patients receiving initial En bloc resection of bladder tumor (ERBT) is still unknown. PubMed, Embase, Web of Science, The Cochrane Library, and China National Knowledge Infrastructure (CNKI) were systematically searched. Finally, this systematic review and meta-analysis included twelve articles, including 539 patients. The rates of residual tumor and tumor upstaging detected by reTURB after ERBT were 5.9% (95%CI, 2.0%-11.1%) and 0.0% (95%CI, 0.0%-0.5%), respectively. Recurrence-free survival, tumor recurrence and progression were comparable between patients with and without reTURB after initial ERBT. The pooled hazard ratios of 1-year, 2-year, 3-year and 5-year recurrence-free survival were 0.74 (95%CI, 0.36-1.51; p = 0.40), 0.76 (95%CI, 0.45-1.26; p = 0.28), 0.83 (95%CI, 0.53-1.32; p = 0.43) and 0.83 (95%CI, 0.56-1.23; p = 0.36), respectively. The pooled relative risks of recurrence and progression were 0.87 (95%CI, 0.64-1.20; p = 0.40) and 1.11 (95%CI, 0.54-2.32; p = 0.77), respectively. Current evidence demonstrates that reTURB after ERBT for bladder cancer can detect relatively low rates of residual tumor and tumor upstaging and appears not to improve either recurrence or progression.

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