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Endoscopic intervention versus radical nephroureterectomy for the management of localized upper urinary tract urothelial carcinoma: a systematic review and meta-analysis of comparative studies.
Giulioni, Carlo; Brocca, Carlo; Tramanzoli, Pietro; Stramucci, Silvia; Mantovan, Matteo; Perpepaj, Leonard; Cicconofri, Andrea; Gauhar, Vineet; Merseburger, Axel Stuart; Galosi, Andrea Benedetto; Castellani, Daniele.
Afiliación
  • Giulioni C; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy. carlo.giulioni9@gmail.com.
  • Brocca C; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Tramanzoli P; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Stramucci S; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Mantovan M; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Perpepaj L; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Cicconofri A; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Gauhar V; Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore.
  • Merseburger AS; Department of Urology, University Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany.
  • Galosi AB; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
  • Castellani D; Department of Urology, Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of Marche, 71 Conca Street, 60126, Ancona, Italy.
World J Urol ; 42(1): 318, 2024 May 14.
Article en En | MEDLINE | ID: mdl-38743260
ABSTRACT

OBJECTIVE:

Localized Upper Urinary Tract Urothelial Carcinoma (UTUC) is an uncommon cancer typically detected at an advanced stage. Currently, radical nephroureterectomy (RNU) with bladder cuff excision is the standard treatment for high-risk UTUC. This meta-analysis aims to evaluate the 5-year overall and cancer-specific survival and bladder recurrence rates in studies comparing endoscopic kidney-sparing surgeries (E-KSS) with RNU in localized UTUC. EVIDENCE ACQUISITION We performed a literature search on 20th April 2023 through PubMed, Web of Science, and Scopus. The PICOS model was used for study inclusion P adult patients with localized UTUC; I E-KSS. C RNU; O primary overall survival (OS); secondary cancer-specific survival (CSS), bladder recurrence rate, and metastasis-free survival (MFS). S retrospective, prospective, and randomized studies. EVIDENCE

SYNTHESIS:

Overall, 11 studies involving 2284 patients were eligible for this meta-analysis, 737 in the E-KSS group and 1547 in the RNU group. E-KSS showed a similar overall 5-year OS between E-KSS and RNU, and for low-grade tumors, while 5-year OS favored RNU for high-grade tumors (RR 1.84, 95% CI 1.26-2.69, p = 0.002). No difference emerged for 5-year CSS between the two groups, even when the results were stratified for low- and high grade tumors. Bladder recurrence rate and 5-year MFS were also similar between the two groups.

CONCLUSIONS:

Our review showed that E-KSS is a viable option for patients with localized UTUC with non-inferior oncological outcomes as compared with RNU, except for 5-year OS in high-grade tumors which favoured RNU.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ureterales / Carcinoma de Células Transicionales / Nefroureterectomía / Neoplasias Renales Límite: Humans Idioma: En Revista: World J Urol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ureterales / Carcinoma de Células Transicionales / Nefroureterectomía / Neoplasias Renales Límite: Humans Idioma: En Revista: World J Urol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Alemania