首页膀胱肿瘤治疗及预后证据详情

The impact of preoperative immune checkpoint inhibitors on kidney and bladder cancer surgeries: a systematic review

原文: 2022 年 发布于 Eur Urol Focus 13 卷 第 5 期 486-491 浏览量:235次

作者: Petzold A. P. Lubianca F. N. Passos L. G. Keppler C. K. Becker N. B. Viera C. D. Fay A. P. Carvalhal G. F.

作者单位: Department of Urology Surgery, The First Hospital of Jilin University, Changchun, P.R. China. Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, P.R. China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1002/14651858.CD014887.pub2

关键词: Bladder cancer Hpv Human papillomavirus Meta-analysis

文献简介

Background En bloc tumor resection of bladder tumors (ERBT) is a novel alternative procedure to conventional resection of bladder tumor (cTURBT), which might help to address common problems of the standard method, such as inadequate detrusor muscle in specimens, high re-resection rates and high recurrence rates. Objective To analyze current data on ERBT in efficacy and safety compared to cTURBT. Data sources: PubMed. Study selection Two independent authors identified trials based on keywords and inclusion criteria. A third author was consulted in case of discrepancies. Screening keywords: ERBT, en bloc transurethral resection of bladder tumor, TURBT en bloc. A meta-analysis of 13 studies was performed. The effect size was estimated based on odds ratios and mean differences including their corresponding two-sided 95% confidence intervals. Data synthesis The analyzed studies comprised a homogenous collective in terms of tumor size, tumor multiplicity and tumor stage. Operation time did not significantly differ between the methods. Differences were observed in hospitalization and catheterization time in favor of ERBT. Reported complications did not show clear differences. There was significantly more detrusor muscle in the specimens in the ERBT group. No significant differences were found in recurrence up to 2 years of follow-up. Conclusion ERBT is a safe alternative to conventional TURBT with promising features regarding effective resection of detrusor muscle. More standardized data on recurrence rates, different resection modalities and resection margin results are needed.

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