Zhang Su,Wang Cheng,Zhai Zhenxing,Wang Juan,Niu Jiping,Fu Shengjun,Wang Xinping,Yang Li.Long-term effect of ureteroscopy prior to radical nephroureterectomy for upper tract urothelial carcinoma: a meta-analysis[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):101-106.
Zhang Su,Wang Cheng,Zhai Zhenxing,Wang Juan,Niu Jiping,Fu Shengjun,Wang Xinping,Yang Li.Long-term effect of ureteroscopy prior to radical nephroureterectomy for upper tract urothelial carcinoma: a meta-analysis[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):101-106.DOI:
Long-term effect of ureteroscopy prior to radical nephroureterectomy for upper tract urothelial carcinoma: a meta-analysis
Objective To determine the effect of ureteroscopy (URS) prior to radical nephroureterectomy on the long-term prognosis in treatment of upper tract urothelial carcinoma (UTUC). Methods Computer retrieval was carried out in PubMed
EMBase
Cochrane library
China Biology Medicine disc (CBM)
WanFang Data
VIP database
and China National Knowledge Infrastructure (CNKI) from establishment until February 29
2016 for prospective or retrospective studies on the effect of URS on the prognosis of UTUC. All the collected researches were analyzed by 2 reviewers independently according to our inclusion and exclusion criteria. The quality of the literature was assessed
and the extracted data was systematically analyzed for corresponding hazard ratios (HR) and 95% confidence interval (95%CI) by using Stata 12. Results Thirteen retrospective studies were eligible
including 4 105 patients. The pooled HR of recurrencefree survival (RFS) was not significant in the univariate analysis (HR=0.93
95%CI: 0.73~1.13) or the multivariate analysis (HR=1.13
95%CI: 0.90~1.36). The pooled HR of intravesical recurrence-free survival (IRFS) was HR=1.13
95%CI: 0.82~1.43 in the univariate analysis and HR=1.54
95%CI: 0.97~2.12 in the multivariate analysis. The pooled HR of cancer specific survival (CSS) was significant in the univariate analysis (HR=0.68
95%CI: 0.48~0.88)
but not in the multivariate analysis (HR=0.83
95%CI: 0.54~1.12). The pooled HR of overall survival (OS) was not significant in the univariate (HR=0.87
95%CI: 0.46~1.27). Conclusion Based on our meta-analysis of current evidence
the performance of URS prior to radical nephroureterectomy for UTUC has no adverse effect on longterm recurrence and survival.