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- Title
Comparative evaluation of reproductive organ-preserving versus standard radical cystectomy in female: a meta-analysis and systematic review of perioperative, oncological, and functional outcomes.
- Authors
You, Chengyu; Cheng, Long; Fang, Qixiang; Qing, Liangliang; Li, Qingchao; Liu, Shuai; Wang, Yanan; Li, Rongxin; Dong, Zhilong
- Abstract
Background: To evaluate the perioperative, oncological, and functional outcomes of reproductive organ-preserving radical cystectomy (ROPRC) compared to standard radical cystectomy (SRC) in the treatment of female bladder cancer. Methods: A systematic search was conducted in November 2023 across several scientific databases. We executed a systematic review and cumulative meta-analysis of the primary outcomes of interest, adhering to the PRISMA and AMSTAR guidelines. The study was registered in PROSPERO (CRD42024501522). Results: The meta-analysis included 10 studies with a total of 2015 participants. ROPRC showed a significant reduction in operative time and postoperative fasting period compared to SRC (MD − 45.69, 95% CI − 78.91 ~ − 12.47, p = 0.007, and MD − 0.69, 95% CI − 1.25 ~ − 0.13, p = 0.02, respectively). Functional outcomes, both daytime continence rate (OR 4.94, 95% CI 1.53 ~ 15.91, p = 0.008) and nighttime continence rate (OR 5.91, 95% CI 1.94 ~ 18.01, p = 0.002), and sexual function measured by the Female Sexual Function Index (MD 5.72, 95% CI 0.19 ~ 11.26, p = 0.04), were significantly improved in the ROPRC group. There were no significant differences between ROPRC and SRC in terms of estimated blood loss, length of hospital stay, overall postoperative complications, minor complications or major complications. Oncologically, both procedures showed comparable outcomes with no significant differences in positive surgical margins, tumor recurrence rates, overall survival, cancer-specific survival, recurrence-free survival, or progression-free survival. Conclusions: ROPRC is a viable and effective alternative to SRC in female bladder cancer patients, offering enhanced functional outcomes and similar oncological safety. These findings suggest that ROPRC can improve the quality of life in female bladder cancer patients without compromising the efficacy of cancer treatment.
- Subjects
BLADDER tumors; CYSTECTOMY; MEDICAL information storage &; retrieval systems; TREATMENT effectiveness; META-analysis; CHI-squared test; DESCRIPTIVE statistics; FEMALE reproductive organs; SYSTEMATIC reviews; MEDLINE; ODDS ratio; MEDICAL databases; ONLINE information services; PROGRESSION-free survival; DATA analysis software; CONFIDENCE intervals; QUALITY assurance; OVERALL survival; EVALUATION
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 9, p5041
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-11074-5