Long-term oncologic outcomes of laparoscopic nephroureterectomy versus open nephroureterectomy for upper tract urothelial carcinoma: a systematic review and meta-analysis
| Autor: | Cheng Wang, Li Yang, Sheng-Jun Fu, Su Zhang, You Luo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Urology Surgery and Surgical Specialties 030232 urology & nephrology lcsh:Medicine Cochrane Library General Biochemistry Genetics and Molecular Biology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Laparoscopic nephroureterectomy business.industry General Neuroscience Hazard ratio lcsh:R Retrospective cohort study General Medicine Confidence interval Surgery Meta-analysis Open nephroureterectomy Nephrology Upper tract urothelial carcinoma 030220 oncology & carcinogenesis Observational study General Agricultural and Biological Sciences business |
| Zdroj: | PeerJ PeerJ, Vol 4, p e2063 (2016) |
| ISSN: | 2167-8359 |
| Popis: | Background.Several factors have been validated as predictors of disease recurrence in upper tract urothelial carcinoma. However, the oncological outcomes between different surgical approaches (open nephroureterectomy versus laparoscopic nephroureterectomy, ONU vs LNU) remain controversial. Therefore, we performed a meta-analysis to evaluate the oncological outcomes associated with different surgical approaches.Methods.We conducted an electronic search of the PubMed, Embase, ISI Web of Knowledge and Cochrane Library electronic databases through November 2015, screened the retrieved references, collected and evaluated the relevant information. We extracted and synthesized the corresponding hazard ratios (HRs) and 95% confidence intervals (95% CI) using Stata 13.Results.Twenty-one observational studies were eligible for inclusion in the meta-analysis. The results of the meta-analysis showed no differences in the intravesical recurrence-free survival (IRFS), unspecified recurrence-free survival (UnRFS) and overall survival (OS) between LNUandONU. However, improvements in the extravesical recurrence free survival (ExRFS) and cancer specific survival (CSS) were observed inLNU. The pooled hazard ratios were 1.05 (95% CI [0.92–1.18]) for IRFS, 0.80 (95% CI [0.64–0.96]) for ExRFS, 1.10 (95% CI [0.93–1.28]) for UnRFS, 0.91 (95% CI [0.66–1.17]) for OS and 0.79 (95% CI [0.68–0.91]) for CSS.Conclusion.Based on current evidence, LNU could provide equivalent prognostic effects for upper tract urothelial carcinoma, and had better oncological control of ExRFS and CSS compared to ONU. However, considering all eligible studies with the intrinsic bias of retrospective study design, the results should be interpreted with caution. Prospective randomized trials are needed to verify these results. |
| Databáze: | OpenAIRE |
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