Haichao Yuan1, Xiaofan Chen2, Liangren Liu1, Lu Yang1, Chunxiao Pu1, Jinhong Li1, Yunjin Bai1, Ping Han3, Qiang Wei4. 1. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China. 2. Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China; Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, P.R. China. 3. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China. Electronic address: hanpinghxyy@163.com. 4. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China. Electronic address: weiqiang765@126.com.
Abstract
PURPOSE: After radical nephroureterectomy (RNU), approximately 22% to 47% of patients with upper tract urothelial carcinoma (UTUC) develop a subsequent intravesical recurrence (IVR). Considering this high incidence of occurrence, several risk factors were reported as predictive of IVR after RNU. Until recently, most of the risk factors were still under debate. The aim of study was to conduct a meta-analysis based on the recent literature to explore the risk factors for IVR after RNU for UTUC. PATIENTS AND METHODS: An electronic search of the Medline, Embase, Cochrane Library, CancerLit, and ClinicalTrials.gov databases was performed to identify relevant studies published before May 2013. The studies were included if they reported risk factors related to bladder or IVR after RNU for UTUC. RESULTS: Overall, 40 studies, with 12,010 patients, were included in our meta-analysis. Our study indicated that a statistically significant difference in IVR after RNU was found in the male vs. female patients (odds ratio [OR] = 0.72, 95% CI: 0.59-0.85), ureteral vs. renal pelvis (OR = 1.18, 95% CI: 1.00-1.36), T2-4 vs. Tis, Ta, and T1 (OR = 0.53, 95% CI: 0.40-0.66), larger vs. smaller tumor size (OR = 1.02, 95% CI: 1.01-1.03), and previous/synchronous bladder cancer vs. the absence of bladder cancer (OR = 1.59, 95% CI: 1.26-1.9). No significant differences in IVR after RNU were found in the younger vs. older age groups, multifocal tumors vs. single tumor, G3 vs. G1 and G2, high vs. low grade, N0 vs. N+, concomitant carcinoma in situ vs. the absence of carcinoma in situ, positive vs. negative lymphovascular invasion, open vs. laparoscopic nephroureterectomy, and endoscopic vs. transvesical technique. CONCLUSIONS: Our study showed that female patient; ureteral tumor; larger tumor; Tis, Ta, and T1; and the history of bladder cancer were significant risk factors related to IVR after RNU.
PURPOSE: After radical nephroureterectomy (RNU), approximately 22% to 47% of patients with upper tract urothelial carcinoma (UTUC) develop a subsequent intravesical recurrence (IVR). Considering this high incidence of occurrence, several risk factors were reported as predictive of IVR after RNU. Until recently, most of the risk factors were still under debate. The aim of study was to conduct a meta-analysis based on the recent literature to explore the risk factors for IVR after RNU for UTUC. PATIENTS AND METHODS: An electronic search of the Medline, Embase, Cochrane Library, CancerLit, and ClinicalTrials.gov databases was performed to identify relevant studies published before May 2013. The studies were included if they reported risk factors related to bladder or IVR after RNU for UTUC. RESULTS: Overall, 40 studies, with 12,010 patients, were included in our meta-analysis. Our study indicated that a statistically significant difference in IVR after RNU was found in the male vs. female patients (odds ratio [OR] = 0.72, 95% CI: 0.59-0.85), ureteral vs. renal pelvis (OR = 1.18, 95% CI: 1.00-1.36), T2-4 vs. Tis, Ta, and T1 (OR = 0.53, 95% CI: 0.40-0.66), larger vs. smaller tumor size (OR = 1.02, 95% CI: 1.01-1.03), and previous/synchronous bladder cancer vs. the absence of bladder cancer (OR = 1.59, 95% CI: 1.26-1.9). No significant differences in IVR after RNU were found in the younger vs. older age groups, multifocal tumors vs. single tumor, G3 vs. G1 and G2, high vs. low grade, N0 vs. N+, concomitant carcinoma in situ vs. the absence of carcinoma in situ, positive vs. negative lymphovascular invasion, open vs. laparoscopic nephroureterectomy, and endoscopic vs. transvesical technique. CONCLUSIONS: Our study showed that female patient; ureteral tumor; larger tumor; Tis, Ta, and T1; and the history of bladder cancer were significant risk factors related to IVR after RNU.
Authors: Aurélie Mbeutcha; Morgan Rouprêt; Ashish M Kamat; Pierre I Karakiewicz; Nathan Lawrentschuk; Giacomo Novara; Jay D Raman; Christian Seitz; Evanguelos Xylinas; Shahrokh F Shariat Journal: World J Urol Date: 2016-04-21 Impact factor: 4.226
Authors: Aurélie Mbeutcha; Romain Mathieu; Morgan Rouprêt; Kilian M Gust; Alberto Briganti; Pierre I Karakiewicz; Shahrokh F Shariat Journal: Transl Androl Urol Date: 2016-10
Authors: T van Doeveren; P J van Leeuwen; K K H Aben; M van der Aa; M Barendrecht; E R Boevé; E B Cornel; A G van der Heijden; K Hendricksen; W Hirdes; A Kooistra; B Kroon; A M Leliveld; R P Meijer; H van Melick; B Merks; T M de Reijke; P de Vries; L F A Wymenga; B Wijsman; J L Boormans Journal: Contemp Clin Trials Commun Date: 2018-02-28