首页膀胱肿瘤治疗及预后证据详情

Pioglitazone use in patients with diabetes and risk of bladder cancer: a systematic review and meta-analysis

原文: 2018 年 发布于 World J Urol 8 卷 第 12 期 628-635 浏览量:170次

作者: Yan H. Q. Xie H. Y. Ying Y. F. Li J. F. Wang X. Xu X. Zheng X. Y.

作者单位: Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu. Department of Respiratory, Affiliated Hospital of Chengdu Medical College. Department of Urology, Affiliated Hospital of Chengdu University. Department of Laboratory, Pengzhou People's Hospital, Chengdu, Sichuan, China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1007/s11255-020-02725-2

关键词: Cystectomy/*methods Humans Lymph Node Excision Lymph Nodes/*pathology Lymphatic Metastasis/*diagnosis Urinary Bladder Neoplasms/*pathology/*surgery

文献简介

Purpose: Patients frequently undergo radical cystectomy and urinary diversion for treatment of bladder cancer. However, they remain at risk of urethral recurrence (UR). Studies have determined various risk factors leading to urethral recurrence. However, no publications have weighed the predictive values of these factors. Materials and Methods: Studies published between 1971 and 2016 were retrieved from PubMed, EMBASE and MEDLINE. We used STATA software (Version 12.0) to estimate the pooled risk ratio. Results: Twenty-five publications with 9498 patients were included. Overall, male patients, especially those with concomitant carcinoma in situ, superficial or intravesical bladder cancer, non-orthotopic diversion, prostatic involvement, bladder neck involvement, positive urethral margins or multifocal bladder cancer were at higher risk of urethral recurrence. The overall risks of recurrence, reported as risk ratios, varied widely. Among all 25 studies, 118 (60.2%) cases in 9 studies were diagnosed through routine follow-up. Another 82 (40.8%) patients in 11 studies first reported symptomatic abnormalities. Prognoses were worse for patients with symptomatic recurrence. Urethral cytology was the most common diagnostic method. Treatment after UR was reported for 272 cases in 14 publications, and 190 patients underwent urethrectomy and 52 underwent urethra-sparing treatments. Outcomes after UR were described in 12 studies reporting 180 cases, and 41 patients were alive through the end of follow-up and 65 patients died of bladder cancer. Conclusions: UR following radical cystectomy for bladder cancer was closely related to risk factors. Precautions, strict follow-up protocols and rational therapies were critical to patients with high risks of urethral recurrences.

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