Year: 2017
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: INTRODUCTION AND OBJECTIVES: In the current era, the ureteroscopy (URS) has become a powerful tool to diagnose and treat patients with upper tract urothelial carcinoma (UTUC).However, there is concern that it may have a negative impact on the patients.We aim to investigate whether the URS before RNU for UTUC has impact on oncologic outcomes.METHODS: We performed a systematic literature search of PubMed, Embase, and Cochrane library for citations published prior to June 2016, describing URS performed among patients with UTUC and conducted a standard meta-analysis of survival outcomes.RESULTS: Our meta-analysis included eight eligible studies containing 2998 patients.The results were as follows: cancer-specific survival(CSS) (Hazard Ratio(HR) ¼ 0.74, 95% confidence interval(CI): 0.59-0.94,P ¼ 0.01), overall survival(OS) (HR ¼ 0.76, 95% CI: 0.48-1.21,P ¼ 0.24), recurrence-free survival(RFS) (HR ¼ 0.89, 95%CI: 0.69-1.14,P ¼ 0.37), metastasis-free survival(MFS) (HR ¼ 1.06, 95% CI: 0.82-1.36,P ¼ 0.66), and intravesical recurrence-free survival(IRFS) (HR ¼ 1.54, 95% CI: 1.31-1.80,P < 0.00001).Besides, excluding the previous bladder tumor history, the results of IRFS were HR ¼ 1.83, 95% CI: 1.55-2.15,and P < 0.00001.CONCLUSIONS: This meta-analysis indicated that URS before RNU did not have a negative impact on CSS, OS, RFS and MFS in UTUC patients.However, patients are at higher risk for intravesical recurrence after RNU when they have undergone prior URS.Further studies are needed to assess the effects of post-URS intravesical chemotherapy on intravesical recurrence.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2604293615