Type 1 Diabetes Mellitus and Incident Bladder Cancer: A Systematic Review and Meta-analysis
作者：
Oskoui H. B.
Bogumil D. D.
Kysh L.
Barrett M.
Siegmund K.
Cortessis V. K.
作者单位：
Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland. Division of Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, QC, Canada. Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. Department of Urology, Weill Cornell Medical College, New York, NY, USA. shahrokh.shariat@meduniwien.ac.at. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. shahrokh.shariat@meduniwien.ac.at. Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. shahrokh.shariat@meduniwien.ac.at. Insitute for Urology and Reproductive Health, I.M., Sechenov First Moscow State Medical University, Moscow, Russia. shahrokh.shariat@meduniwien.ac.at.
归属分类：
膀胱肿瘤治疗及预后证据
DOI：
10.1042/BSR20202127
关键词：
Aged
Catheterization
Chemotherapy
Adjuvant
Feasibility Studies
Female
Humans
*Laser Therapy
Length of Stay
Male
Middle Aged
Operative Time
Postoperative Complications/etiology
Time Factors
Treatment Outcome
Urinary Bladder Neoplasms/drug therapy/pathology/*radiotherapy/*surgery
Bladder tumor
Laser enucleation of bladder tumor
Meta-analysis
Transurethral resection of bladder tumor (TURBT)
INTRODUCTION: Robotic assisted radical cystectomy (RARC) is gaining popularity worldwide, although its enthusiastic implementation is supported mainly by retrospective studies. Aim of this review is to compare the outcomes of RARC and open radical cystectomy (ORC) in the setting of randomized controlled trials (RCTs). EVIDENCE ACQUISITION: Three search engines (PubMed, Embase®, and Web of Science) were queried up to January 1, 2019. Studies selections followed The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Statement to find studies regarding patients with clinically localized muscle invasive and high risk non muscle invasive bladder cancer who underwent RARC or ORC to evaluate surgical, pathological, and oncological outcomes. The statistical analysis was performed with RevMan 5.3. EVIDENCE SYNTHESIS: Five randomized controlled trial were identified. We found RARC group to be not associated to neoadjuvant chemotherapy (OR: 0.67; 95%CI: 0.46, 0.98; P=0.04). ORC had shorter operative time (OT) (WMD: 95.14 minutes; 95%CI: 50.59, 139.68; P<0.0001), whereas RARC showed to provide lower estimated blood loss (EBL) (WMD: -277.60 mL; 95%CI: -471.02, -84.18; P=0.005). RARC demonstrated lower risk of transfusions compared to the ORN group (OR: 0.52; 95%CI: 0.32, 0.85; P=0.008) as well as shorter LOS (WMD: -0.92 days; 95%CI: -1.46, -0.37; P=0.001). No difference was recorded in terms of pathological and oncological outcomes. CONCLUSIONS: RARC does exhibit known benefits of minimally invasive surgery, although the impact of an enhanced recovery pathway is probably more important than the surgical approach in determining post-operative morbidity. To date, well designed prospective studies have found that RARC yields non-inferior oncologic outcomes compared to ORC.