Incidence, risk factors and outcomes of urethral recurrence after radical cystectomy for bladder cancer: A systematic review and meta-analysis
Language English Country United States Media print-electronic
Document type Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
PubMed
34266740
DOI
10.1016/j.urolonc.2021.06.009
PII: S1078-1439(21)00267-2
Knihovny.cz E-resources
- Keywords
- Radical cystectomy, Risk factors, UR, RC, Urethral recurrence,
- MeSH
- Cystectomy methods MeSH
- Incidence MeSH
- Humans MeSH
- Neoplasm Recurrence, Local MeSH
- Urinary Bladder Neoplasms surgery MeSH
- Risk Factors MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
- Research Support, Non-U.S. Gov't MeSH
- Systematic Review 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 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
Institute for Urology and Reproductive Health Sechenov University Moscow Russia
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
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