Oncologic outcomes of Bacillus Calmette-Guérin therapy in elderly patients with non-muscle-invasive bladder cancer: A meta-analysis

原文： 2022 年发布于现代泌尿生殖肿瘤杂志 18 卷第 11 期 2750-2761  浏览量：185次

作者： Aghamir S. M. K. Khatami F. Farrokhpour H. Oliveira Reis L. Ahmadi Pishkuhi M. Mohammadi A.

作者单位： Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University Hospital of Tours, Tours, France. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University Hospital Zurich, Zurich, Switzerland. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland Department of Urology and Division of Experimental Oncology, Urological Research Institute, Vita-Salute San Raffaele. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia Department of Urology, Weill Cornell Medical College, New York, USA Department of Urology, University of Texas Southwestern, Dallas, Texas, USA Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan European Association of Urology Research Foundation, Arnhem, Netherlands. Electronic address: shahrokh.shariat@meduniwien.ac.at.

归属分类：膀胱肿瘤治疗及预后证据

DOI： 10.7150/ijms.49228

关键词： Cystectomy/*methods Humans *Margins of Excision Survival Rate Ureter/*surgery Urinary Bladder Neoplasms/mortality/*surgery Bladder cancer Cancer de vessie Cystectomie Cystectomy Examen extemporané Frozen section Recoupes urétérales Ureteral margin

目的系统评价经尿道铥激光手术治疗非肌层浸润性膀胱癌的疗效。方法检索 PubMed 、 Embase 、 Web of Science 、 Cochrane Library 、万方数据库、中国知网、维普等数据库中有关经尿道铥激光和经尿道等离子电切术治疗非肌层浸润性膀胱癌的对照研究，按照纳入和排除标准筛选文献并进行质量评价，将围手术期指标及术后不同时间节点的复发率作为评价指标。结果总共纳入 17 篇文献，包含 2 249 例患者。 Meta 分析结果显示，铥激光组的术中出血量低于等离子电切组 (MD=-13.78,95%CI:-18.38 ～ -9.18,P<0.001], 术后住院时间 (MD=-1.68,95%CI:-2.39 ～ -0.96,P<0.001) 、导尿管留置时间 (MD=-1.07,95%CI:-1.51 ～ -0.63,P<0.001) 及膀胱冲洗时间 (MD=-14.21,95%CI:-16.72 ～ -11.70,P<0.001) 均短于等离子电切组，闭孔神经反射 (OR=0.06,95%CI:0.03 ～ 0.12,P<0.001) 、膀胱穿孔 (OR=0.12,95%CI:0.04 ～ 0.32,P<0.001) 及膀胱刺激征 (OR=0.28,95%CI:0.09 ～ 0.90,P<0.001) 发生率均低于等离子电切组。两组手术时间比较差异无统计学意义 (MD=0.54,95%CI:-3.66 ～ 4.75,P=0.800) 。两组术后 1 年复发率比较差异无统计学意义 (OR=0.82,95%CI:0.59 ～ 1.15,P=0.250); 术后 2 年复发率比较，铥激光组低于等离子电切组 (OR=0.60,95%CI:0.40 ～ 0.92,P=0.018) 。结论经尿道铥激光手术在术中出血量、术后住院时间、导尿管留置时间及膀胱冲洗时间方面具有明显的优势，在闭孔神经反射、膀胱穿孔、膀胱刺激征及术后 2 年复发等方面具有更低的发生率，疗效优于经尿道等离子电切术。