The prognostic value of concomitant carcinoma in situ in patients with upper tract urinary carcinoma after radical nephroureterectomy: an systematic review and Meta-analysis
10.3760/cma.j.issn.1000-6702.2020.01.010
- VernacularTitle: 伴原位癌的上尿路尿路上皮癌患者行根治性肾输尿管切除术的预后荟萃分析
- Author:
Lijin ZHANG
1
;
Zhenlei ZHA
;
Hu ZHAO
;
Jun YUAN
;
Peng GUO
;
Yejun FENG
;
Bin WU
Author Information
1. Department of Urology, Affiliated Jiangyin Hospital of the Southeast University Medical College, Jiangyin 214431, China
- Publication Type:Clinical Trail
- Keywords:
Urologic diseases;
Upper tract urinary carcinoma;
Radical nephroureterectomy;
Concomitant carcinoma in situ;
Prognosis;
Meta-analysis
- From:
Chinese Journal of Urology
2020;41(1):51-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective:The aim of this study was to evaluate the influence of concomitant carcinoma in situ (CCIS) on tumor survival for the upper tract urinary carcinoma (UTUC) through systematic review and meta-analysis.
Methods:In the light of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, a systematic search of Web of Science, PubMed and EMBASE China National Knowledge Infrastructure (CNKI) and Wanfang database by key words "upper urinary tract urothelial carcinoma" "renal sputum cancer" "concomitant carcinoma in situ" , and "radical ureterectomy" were performed for all reports that included detailed results on the predictors of CCIS. The search deadline is June 2019, and the search terms are English and Chinese. Methodological quality evaluation was performed using the QUIPS tool, and statistical analysis of the relevant data was performed using Stata 12.0 and RevMan 5.3 software.
Results:Sixteen articles were included in this study and all published between 2012 and 2019. A total of 11 131 patients with UTUC, including 1 774 (15.9%) patients with CCIS. According to our final results, there was a significant correlation of CCIS with worse cancer-specific survival (CSS) (HR=1.10, 95%CI 1.05-1.16, P<0.001), recurrence-free survival (RFS) (HR=1.15, 95%CI 1.09-1.21, P<0.001) and overall survival (OS) (HR=1.10, 95%CI 1.03-1.17, P=0.003). Begg′s bias analysis showed no significant publication bias in CSS (P=0.822), RFS (P=0.348), and OS (P=0.452).
Conclusions:This study demonstrated that CCIS was associated with poor oncological outcome and could serve as a independent prognostic factor for patient with UTUC after radical nephroureterectomy.
