Impact of perioperative blood transfusions on oncologic outcomes after radical cystectomy: A systematic review and meta-analysis of comparative studies
作者：
Uysal D.
Egen L.
Grilli M.
Wessels F.
Lenhart M.
Michel M. S.
Kriegmair M. C.
Kowalewski K. F.
作者单位：
Department of Urology, Careggi Hospital, University of Florence, Florence, Italy. USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Urology, Bichat-Claude Bernard Hospital, APHP, Paris University, Paris, France. Department of Urology, Urological Research Institute, San Raffaele Scientific Institute, Milan, Italy. Urology, GRC 5 PREDICTIVE ONCO-URO, AP-HP, Sorbonne University, Pitié-Salpêtrière Hospital, Paris, France. Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
Department of Urology, Weill Cornell Medical College, New York, NY, USA
Department of Urology, University of Texas Southwestern, Dallas, TX, USA
Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
Department of Urology, University of Jordan, Amman, Jordan
European Association of Urology research foundation, Arnhem, The Netherlands. Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland. Electronic address: marco.moschini87@gmail.com.
归属分类：
膀胱肿瘤病因/危险因素证据
DOI：
10.5455/medarh.2022.76.198-201
关键词：
Combined Modality Therapy
Humans
Light
Narrow Band Imaging
*Urinary Bladder Neoplasms/diagnostic imaging/surgery
cystoscopy
recurrence
urinary bladder neoplasms
Objective We conducted a systematic review and meta-analysis to assess the available literature regarding the surgical and oncologic outcomes of patients undergoing salvage radical cystectomy (SV-RC) for recurrence or failure of bladder sparing therapy (BST) for muscle-invasive bladder cancer (MIBC). Methods We searched MEDLINE (PubMed), EMBASE and Google Scholar databases in May 2020. We included all studies of patients with >= cT2N0/xM0 bladder cancer that were eligible for all treatment modalities at the time of treatment decision who underwent BST including radiotherapy (RTX). A meta-analysis was conducted to calculate the pooled rate of several variables associated with an increased need for SV-RC. Study quality and risk of bias were assessed using MINORS criteria. Results 73 studies comprising 9110 patients were eligible for the meta-analysis. Weighted mean follow-up time was 61.1 months (range 12-144). The pooled rate of non-response to BST and local recurrence after BST, the two primary reasons for SV-RC, was 15.5% and 28.7%, respectively. The pooled rate of SV-RC was 19.2% for studies with a follow-up longer than 5 years. Only three studies provided a thorough report of complication rates after SV-RC. The overall complication rate ranged between 67 and 72% with a 30-day mortality rate of 0-8.8%. The pooled rates of 5 and 10-year disease-free survival after SV-RC were 54.3% and 45.6%, respectively. Conclusion Approximately one-fifth of patients treated with BST with a curative intent eventually require SV-RC. This procedure carries a proportionally high rate of complications and is usually accompanied by an incontinent urinary diversion.