PURPOSE: We aimed to elucidate the relation between extracapsular extension (ECE) and clinical outcomes in node-positive patients following radical cystectomy for bladder cancer. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, SCOPUS, Web of Science, and Cochrane Library databases from their respective dates of inception until September 2014. RESULTS: Ten articles that met the eligibility criteria included 43-748 subjects per study, with the total number of patients being 1,893. The frequency of ECE ranged from 36.6 to 58.1 %. The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (RFS) [pooled HR 1.56; 95 % confidence interval (CI) 1.13-2.14] and cancer-specific survival (CSS) (pooled HR 1.60; 95 % CI 1.29-1.99) but not overall survival (OS) (pooled HR 1.47; 95 % CI 0.71-3.05). Heterogeneity in RFS (I (2) 84 %, p < 0.00001) and OS (I (2) 80 %, p = 0.03) was statistically significant. According to subgroup analysis with meta-regression analyses, "region" (pheterogeneity < 0.0001) and "analysis results" (pheterogeneity < 0.0001) were the sources of heterogeneity. Sensitivity analysis showed that omission of any study did not lead to a significant difference. No statistical evidence of publication bias regarding RFS or CSS was revealed among the studies using Begg's and Egger's tests. CONCLUSIONS: This meta-analysis shows that ECE is an efficient prognostic factor for node-positive bladder cancer. However, large prospective studies are needed to confirm the clinical utility of ECE as an independent prognostic factor before these results can be applied clinically.
PURPOSE: We aimed to elucidate the relation between extracapsular extension (ECE) and clinical outcomes in node-positive patients following radical cystectomy for bladder cancer. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, SCOPUS, Web of Science, and Cochrane Library databases from their respective dates of inception until September 2014. RESULTS: Ten articles that met the eligibility criteria included 43-748 subjects per study, with the total number of patients being 1,893. The frequency of ECE ranged from 36.6 to 58.1 %. The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (RFS) [pooled HR 1.56; 95 % confidence interval (CI) 1.13-2.14] and cancer-specific survival (CSS) (pooled HR 1.60; 95 % CI 1.29-1.99) but not overall survival (OS) (pooled HR 1.47; 95 % CI 0.71-3.05). Heterogeneity in RFS (I (2) 84 %, p < 0.00001) and OS (I (2) 80 %, p = 0.03) was statistically significant. According to subgroup analysis with meta-regression analyses, "region" (pheterogeneity < 0.0001) and "analysis results" (pheterogeneity < 0.0001) were the sources of heterogeneity. Sensitivity analysis showed that omission of any study did not lead to a significant difference. No statistical evidence of publication bias regarding RFS or CSS was revealed among the studies using Begg's and Egger's tests. CONCLUSIONS: This meta-analysis shows that ECE is an efficient prognostic factor for node-positive bladder cancer. However, large prospective studies are needed to confirm the clinical utility of ECE as an independent prognostic factor before these results can be applied clinically.
Authors: Paolo Borghetti; Fernando Barbera; Marco Lorenzo Bonù; Francesca Trevisan; Stefano Ciccarelli; Paola Vitali; Marta Maddalo; Luca Triggiani; Nadia Pasinetti; Sara Pedretti; Bartolomea Bonetti; Gianluca Pariscenti; Andrea Tironi; Alberto Caprioli; Michela Buglione; Stefano Maria Magrini Journal: Radiol Med Date: 2016-05-26 Impact factor: 3.469
Authors: Peter A S Johnstone; David Boulware; Rosa Djajadiningrat; Sarah Ottenhof; Andrea Necchi; Mario Catanzaro; Dingwei Ye; Yao Zhu; Nicola Nicolai; Simon Horenblas; Philippe E Spiess Journal: Eur Urol Focus Date: 2018-10-14
Authors: Helena Link; Martin Angele; Miriam Schüller; Petra Ganschow; Lena Machetanz; Markus Guba; Jens Werner; Thomas Kirchner; Jens Neumann Journal: BMC Cancer Date: 2018-04-27 Impact factor: 4.430