首页膀胱肿瘤治疗及预后证据详情

Tea Consumption and Risk of Bladder Cancer: A Dose-Response Meta-Analysis

原文: 2017 年 发布于 Pharmacoepidemiology and Drug Safety 浏览量:166次

作者: Weng H. Zeng X. T. Li S. Kwong J. S. W. Liu T. Z. Wang X. H.

作者单位: Urology Department, Northern Ontario School of Medicine, Thunder Bay, Ontario Canada. GRID: grid.436533.4. ISNI: 0000 0000 8658 0974 Urology Department, Alexandria University, Alexandria, Egypt. GRID: grid.7155.6. ISNI: 0000 0001 2260 6941

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.eururo.2021.04.030

文献简介

INTRODUCTION: Different sexual function-preserving surgical techniques aimed at improving voiding and sexual function in patients undergoing radical cystectomy for bladder cancer have been described. The objective of this systematic review is to determine the effect of sexual function-preserving cystectomy (SPC) on functional and oncological outcomes. MATERIALS AND METHODS: Relevant databases were searched covering the time frame 2000 to 2015. All publications presenting data on any type of SPC reporting oncological or functional outcomes with a minimum follow-up of 1 year were identified. Comparative studies including a minimum of 30 patients and single-arm case series with a minimum of 50 patients were selected. No language restrictions were applied. RESULTS: In a total of 8,517 identified abstracts, 12 studies were eligible for inclusion. SPC described included prostate-, capsule-, seminal vesicle, and nerve-sparing techniques. Local recurrence ranged from 1.2% to 61.1% (vs. 16.0%-55.0% in the control group) and metastatic disease from 0% to 33.3% (vs. 33.0%). No differences were found in comparative studies reporting oncological outcomes. Postoperative potency was significantly better in the SPC groups in 6 studies comparing sexual function-preserving cystectomy vs. radical cystectomy (P<0.05). No major effect on continence was found. Overall, there was moderate to high risk of bias and confounding. CONCLUSIONS: The evidence base for prostate-, capsule-, or nerve-sparing cystectomy suggests that these procedures may yield better sexual outcomes than standard cystectomy, without compromising oncological outcomes. However, the overall quality of the evidence was moderate, and hence if offered, patients must be carefully selected, counseled, and closely monitored.

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