Hyung Suk Kim1, Myong Kim1, Chang Wook Jeong1, Cheol Kwak1, Hyeon Hoe Kim1, Ja Hyeon Ku2. 1. Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Urology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kuuro70@snu.ac.kr.
Abstract
OBJECTIVES: This study aimed to elucidate the relationship between lymphovascular invasion (LVI) at transurethral resection of bladder tumor (TURBT) and the risk of pathologic upstaging as well as the clinical outcomes. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Cochrane Library databases were searched from the respective dates of inception until November 11, 2013. RESULTS: A total of 16 articles met the eligibility criteria for this systematic review, which included a total of 3,905 patients. LVI was detected in 18.6% of TURBT specimens. A significant association was found between LVI at TURBT and pathologic upstaging of bladder cancer (odds ratio = 2.21, 95% CI: 1.44-3.39) without heterogeneity (I(2) = 45%, P = 0.14). The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (HR = 1.47, 95% CI: 1.24-1.74), progression-free survival (HR = 2.28, 95% CI: 1.45-3.58), and disease-specific survival (HR = 1.35, 95% CI: 1.01-1.81), but not for overall survival (HR = 1.55, 95% CI: 0.90-2.67). Tests of inconsistency for disease-specific survival (I(2) = 66%, P = 0.007) and overall survival (I(2) = 72%, P = 0.03) could not exclude a significant heterogeneity. The results of the Begg and the Egger tests showed that there was evidence of publication bias on pathologic upstaging and progression-free survival. CONCLUSIONS: The data obtained in this meta-analysis indicate that the presence of LVI at TURBT portends the increased risk of pathologic upstaging and may provide additional prognostic information. However, a large, well-designed, prospective study is needed to investigate potential treatment options for bladder cancer with LVI.
OBJECTIVES: This study aimed to elucidate the relationship between lymphovascular invasion (LVI) at transurethral resection of bladder tumor (TURBT) and the risk of pathologic upstaging as well as the clinical outcomes. MATERIALS AND METHODS: PubMed, Scopus, Web of Science, and Cochrane Library databases were searched from the respective dates of inception until November 11, 2013. RESULTS: A total of 16 articles met the eligibility criteria for this systematic review, which included a total of 3,905 patients. LVI was detected in 18.6% of TURBT specimens. A significant association was found between LVI at TURBT and pathologic upstaging of bladder cancer (odds ratio = 2.21, 95% CI: 1.44-3.39) without heterogeneity (I(2) = 45%, P = 0.14). The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (HR = 1.47, 95% CI: 1.24-1.74), progression-free survival (HR = 2.28, 95% CI: 1.45-3.58), and disease-specific survival (HR = 1.35, 95% CI: 1.01-1.81), but not for overall survival (HR = 1.55, 95% CI: 0.90-2.67). Tests of inconsistency for disease-specific survival (I(2) = 66%, P = 0.007) and overall survival (I(2) = 72%, P = 0.03) could not exclude a significant heterogeneity. The results of the Begg and the Egger tests showed that there was evidence of publication bias on pathologic upstaging and progression-free survival. CONCLUSIONS: The data obtained in this meta-analysis indicate that the presence of LVI at TURBT portends the increased risk of pathologic upstaging and may provide additional prognostic information. However, a large, well-designed, prospective study is needed to investigate potential treatment options for bladder cancer with LVI.
Authors: Francesco Soria; Francesca Pisano; Paolo Gontero; J Palou; S Joniau; V Serretta; S Larré; S Di Stasi; B van Rhijn; J A Witjes; A Grotenhuis; R Colombo; A Briganti; M Babjuk; V Soukup; P U Malmstrom; J Irani; N Malats; J Baniel; R Mano; T Cai; E Cha; P Ardelt; J Varkarakis; R Bartoletti; G Dalbagni; S F Shariat; E Xylinas; R J Karnes; R Sylvester Journal: World J Urol Date: 2018-08-31 Impact factor: 4.226
Authors: Jeremy W Martin; Simone L Vernez; Yair Lotan; Ahmed Abdelhalim; Rahul Dutta; Ahmed Shokeir; Hassan Abol-Enein; Ahmed Mosbah; Mohamed Ghoneim; Ramy F Youssef Journal: World J Urol Date: 2018-05-14 Impact factor: 4.226