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Incidence, risk factors and outcomes of urethral recurrence after radical cystectomy for bladder cancer: A systematic review and meta-analysis
E. Laukhtina, K. Mori, D. D Andrea, M. Moschini, M. Abufaraj, F. Soria, A. Mari, W. Krajewski, S. Albisinni, JY. Teoh, F. Quhal, R. Sari Motlagh, H. Mostafaei, S. Katayama, NС. Grossmann, P. Rajwa, D. Enikeev, K. Zimmermann, H. Fajkovic, P....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, metaanalýza, práce podpořená grantem, systematický přehled
- MeSH
- cystektomie metody MeSH
- incidence MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- nádory močového měchýře chirurgie MeSH
- rizikové faktory MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- systematický přehled MeSH
We aimed to conduct a systematic review and meta-analysis assessing the incidence and risk factors of urethral recurrence (UR) as well as summarizing data on survival outcomes in patients with UR after radical cystectomy (RC) for bladder cancer. The MEDLINE and EMBASE databases were searched in February 2021 for studies of patients with UR after RC. Incidence and risk factors of UR were the primary endpoints. The secondary endpoint was survival outcomes in patients who experienced UR. Twenty-one studies, comprising 9,435 patients, were included in the quantitative synthesis. Orthotopic neobladder (ONB) diversion was associated with a decreased probability of UR compared to non-ONB (pooled OR: 0.44, 95% CI: 0.31-0.61, P < 0.001) and male patients had a significantly higher risk of UR compared to female patients (pooled OR: 3.16, 95% CI: 1.83-5.47, P < 0.001). Among risk factors, prostatic urethral or prostatic stromal involvement (pooled HR: 5.44, 95% CI: 3.58-8.26, P < 0.001; pooled HR: 5.90, 95% CI: 1.82-19.17, P = 0.003, respectively) and tumor multifocality (pooled HR: 2.97, 95% CI: 2.05-4.29, P < 0.001) were associated with worse urethral recurrence-free survival. Neither tumor stage (P = 0.63) nor CIS (P = 0.72) were associated with worse urethral recurrence-free survival. Patients with UR had a 5-year CSS that varied from 47% to 63% and an OS - from 40% to 74%; UR did not appear to be related to worse survival outcomes. Male patients treated with non-ONB diversion as well as patients with prostatic involvement and tumor multifocality seem to be at the highest risk of UR after RC. Risk-adjusted standardized surveillance protocols should be developed into clinical practice after RC.
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology and Oncologic Urology Wrocław Medical University Wroclaw Poland
Department of Urology Careggi Hospital University of Florence Florence Italy
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology Federal Armed Services Hospital Koblenz Koblenz Germany
Department of Urology King Fahad Specialist Hospital Dammam Saudi Arabia
Department of Urology Luzerner Kantonsspital Lucerne Switzerland
Department of Urology Medical University of Silesia Zabrze Poland
Department of Urology The Jikei University School of Medicine Tokyo Japan
Department of Urology University Hospital Zurich Zurich Switzerland
Department of Urology University of Texas Southwestern Dallas TX
Department of Urology Weill Cornell Medical College New York New York NY
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Research Center for Evidence Based Medicine Tabriz University of Medical Sciences Tabriz Iran
S H Ho Urology Centre Department of Surgery The Chinese University of Hong Kong Hong Kong China
Service d'Urologie Hôpital Erasme Université Libre de Bruxelles Bruxelles Belgium
Citace poskytuje Crossref.org
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- $a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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- $a Incidence, risk factors and outcomes of urethral recurrence after radical cystectomy for bladder cancer: A systematic review and meta-analysis / $c E. Laukhtina, K. Mori, D. D Andrea, M. Moschini, M. Abufaraj, F. Soria, A. Mari, W. Krajewski, S. Albisinni, JY. Teoh, F. Quhal, R. Sari Motlagh, H. Mostafaei, S. Katayama, NС. Grossmann, P. Rajwa, D. Enikeev, K. Zimmermann, H. Fajkovic, P. Glybochko, SF. Shariat, B. Pradere, European Association of Urology–Young Academic Urologists Urothelial Carcinoma Working Group (EAU-YAU)
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- $a We aimed to conduct a systematic review and meta-analysis assessing the incidence and risk factors of urethral recurrence (UR) as well as summarizing data on survival outcomes in patients with UR after radical cystectomy (RC) for bladder cancer. The MEDLINE and EMBASE databases were searched in February 2021 for studies of patients with UR after RC. Incidence and risk factors of UR were the primary endpoints. The secondary endpoint was survival outcomes in patients who experienced UR. Twenty-one studies, comprising 9,435 patients, were included in the quantitative synthesis. Orthotopic neobladder (ONB) diversion was associated with a decreased probability of UR compared to non-ONB (pooled OR: 0.44, 95% CI: 0.31-0.61, P < 0.001) and male patients had a significantly higher risk of UR compared to female patients (pooled OR: 3.16, 95% CI: 1.83-5.47, P < 0.001). Among risk factors, prostatic urethral or prostatic stromal involvement (pooled HR: 5.44, 95% CI: 3.58-8.26, P < 0.001; pooled HR: 5.90, 95% CI: 1.82-19.17, P = 0.003, respectively) and tumor multifocality (pooled HR: 2.97, 95% CI: 2.05-4.29, P < 0.001) were associated with worse urethral recurrence-free survival. Neither tumor stage (P = 0.63) nor CIS (P = 0.72) were associated with worse urethral recurrence-free survival. Patients with UR had a 5-year CSS that varied from 47% to 63% and an OS - from 40% to 74%; UR did not appear to be related to worse survival outcomes. Male patients treated with non-ONB diversion as well as patients with prostatic involvement and tumor multifocality seem to be at the highest risk of UR after RC. Risk-adjusted standardized surveillance protocols should be developed into clinical practice after RC.
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- $a Mori, Keiichiro $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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