首页膀胱肿瘤治疗及预后证据详情

Association Between Estrogen Receptors and GATA3 in Bladder Cancer: A Systematic Review and Meta-Analysis of Their Clinicopathological Significance

原文: 2021 年 发布于 Medicine 104 卷 第 52 期 S1322-S1322 浏览量:186次

作者: Bernardo C. Monteiro F. L. Direito I. Amado F. Afreixo V. Santos L. L. Helguero L. A.

作者单位: Department of Urology, First Hospital of Shanxi Medical University First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, China. First College of Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.11152/mu-2730

关键词: 膀胱肿瘤 激光 尿道电切 Meta分析

文献简介

BACKGROUND: En bloc transurethral resection (ERBT) is a major topic of discussion as an alternative to conventional transurethral resection (cTURBT) for the treatment of non-muscle-invasive bladder cancer (NMIBC) addressing the limitations of cTURBT. METHODS: We searched through electronic databases including Embase, Cochrane Library, MEDLINE, Web of Science, PubMed, and Google Scholar for articles published up to April 1, 2019; RevMan 5.3 was used to conduct this meta-analysis. Results were expressed as 95% confidence intervals (CI) and risk differences (RD). RESULTS: Nine trials met the inclusion criteria (n = 1,020 patients): 1 study was a randomized controlled trial including a total of 142 participants, 4 studies had a prospective paired design including 605 patients, and 4 studies were retrospective (n = 273 patients). Duration of continuous postoperative bladder irrigation (RD -0.16; 95% CI -3.47 to 0.28; I2 = 97%; p = 0.10) and operation time (RD 0.05; 95% CI -0.23 to 0.32; I2 = 79%; p = 0.74) were not significantly different between ERBT and cTURBT. However, hospitalization time (I2 = 96%; χ2 = 203.16; p = 0.01) and catheterization time (I2 = 95%; χ2 = 163.24; p = 0.02), as well as 24-month recurrence rate (I2 = 0%; χ2 = 0.98; p = 0.008) were significantly better using the ERBT scheme. The incidence of urethral stricture between both schemes (95% CI -0.03 to 0.02; p = 0.50) was not different, but complications such as obturator nerve reflex (95% CI 0.01 to 0.12; p < 0.00001) and bladder perforation (95% CI 0.05 to 0.59; p = 0.50) were less frequent in the ERBT group. CONCLUSION: ERBT is an effective treatment approach with some advantages for NMIBC. Our meta-analysis revealed that hospitalization time, catheterization time, and 24-month recurrence rate is superior in patients treated with ERBT than cTURBT, and ERBT patients also have a lower complication rate. Furthermore, ERBT improves the quality of tumor specimens and decreases the frequency of repeat transurethral bladder cancer resection. Further randomized controlled trials are needed to confirm our results.

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