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Concomitant carcinoma in situ as a prognostic factor in the upper tract urothelial carcinoma after radical nephroureterectomy: A systematic review and meta-analysis.

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机构: [1]Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
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关键词: Upper tract urothelial carcinoma Carcinoma in situ Radical nephroureterectomy Prognosis Meta-analysis

摘要:
Some excised specimens of upper tract urothelial carcinoma (UTUC) are concomitant carcinoma in situ (CIS). However, whether concomitant CIS affects the prognosis of UTUC is controversial. The objective of this study was to provide a comprehensive association between CIS and the prognosis of UTUC. Web of Science, PubMed, and Embase were searched to identify clinical studies about CIS and UTUC before July 2019. Newcastle Ottawa Scale was used to evaluate the quality of the literature. We calculated hazard ratios (HRs) and 95% CIs to evaluate the relationship between concomitant CIS and survival outcomes. Z test was used to pooled HRs, if P < 0.05, the difference was considered statistically significant. Total of 7,852 patients with UTUC were included, of which 1,004 (12.79%) concomitant CIS. In univariate analysis, our meta-analysis shows that concomitant CIS is associated with worse cancer-specific survival (HR: 1.54; P < 0.00001), worse recurrence-free survival (RFS) (HR: 1.42; P < 0.00001) and worse overall survival (OS; HR: 1.41; P = 0.04). In multivariate analysis, concomitant CIS is associated with worse cancer-specific survival (HR: 1.25; P = 0.004), worse recurrence-free survival (HR: 1.24; P = 0.006), and worse OS (HR: 1.12; P = 0.25), however, there was no statistical difference in the effect of CIS on OS (P > 0.05). Our meta-analysis shows that concomitant CIS is associated with worse survival outcomes in UTUC after radical nephroureterectomy. CIS is an independent prognostic risk factor in UTUC. Copyright © 2020 Elsevier Inc. All rights reserved.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学 4 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学 4 区 肿瘤学
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第一作者机构: [1]Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
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