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- Title
Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma Increased the Risk of Intravesical Recurrence.
- Authors
Tan, Ping; Xie, Nan; Yang, Lu; Liu, Liangren; Tang, Zhuang; Wei, Qiang
- Abstract
Objective: To assess the impact of diagnostic ureteroscopy (URS) prior to radical nephroureterectomy (RNU) on intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC). Materials and Methods: A systematic literature search of the Medline, Embase, PubMed, and Cochrane library was performed in August 2017. Cumulative analyses of available hazard ratios (HRs) and their 95% CI were conducted using Stata version 12.0. Results: Eleven studies including 4,057 participants were included, with a total of 1,403 patients diagnosed with IVR during the followup period. The pooled HRs of eight studies suggested that diagnostic URS prior to RNU significantly increased the IVR risk after RNU (HR 1.53, 95% CI 1.31-1.77; p < 0.001). However, the preoperative diagnostic URS was not associated with cancer-specific survival (HR 0.72; p = 0.11), metastasisfree survival (HR 1.09; p = 0.60) or overall survival (HR 1.12; p = 0.73). No publication bias was observed (Begg, p = 0.90; Egger, p = 0.71). Conclusions: Regardless, the diagnostic URS prior to RNU might increase the IVR risk in patients with UTUC. As ureteroscopy provides important prognostic and therapeutic value and guides decisions in UTUC, more future studies should be performed to find a novel way to mitigate the potential risk of IVR after RNU, such as chemoprophylaxis after endoscopy.
- Subjects
CANCER patients; URETEROSCOPY; METASTASIS; CHEMOPREVENTION; ENDOSCOPY; PATIENTS
- Publication
Urologia Internationalis, 2018, Vol 100, Issue 1, p92
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000484417