PD35-08 RISK FACTORS FOR INTRAVESICAL RECURRENCE AFTER RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA: A META-ANALYSIS

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Tumors I1 Apr 2014PD35-08 RISK FACTORS FOR INTRAVESICAL RECURRENCE AFTER RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA: A META-ANALYSIS Haichao Yuan, Ping Han, and Qiang Wei Haichao YuanHaichao Yuan More articles by this author , Ping HanPing Han More articles by this author , and Qiang WeiQiang Wei More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2421AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The standard management for upper tract urothelial carcinoma (UTUC) is radical nephroureterectomy (RNU) with bladder cuff excision, but after surgery, approximately 22% to 47% of patients with UTUC develop subsequent intravesical recurrence (IVR), and recurrence in the contralateral upper tract is observed in 26% of patients. Considering this high incidence of IVR after RNU, several risk factors were reported as predictive for IVR after RNU. Until recently, most of the risk factors were still under debate. The aim of our study is to conduct a meta-analysis based on the recent literature to explore the risk factors for IVR after RNU for UTUC. METHODS An electronic search of the Medline, Embase, Cochrane Library, CancerLit and ClinicalTrials.gov databases was performed to identify relevant studies published prior to May 2013. The studies were included if they reported risk factors related to bladder or intravesical recurrence after RNU for UTUC. Studies were excluded from the analysis if they were case reports, meeting abstracts or conference proceedings. The studies which included neoadjuvant or adjuvant chemotherapy or intravesical instillation chemotherapy after RNU were excluded. RESULTS Forty studies, with 12,010 patients, were included in our meta-analysis. Our study indicated that a statistically significant difference in IVR after RNU was found in the male vs. female (OR: 0.72; 95%CI: 0.59 to 0.85), ureteral vs. renal pelvis (OR: 1.18; 95%CI: 1.00 to 1.36), T2-4 vs. Tis and Ta,1 (OR: 0.53; 95%CI: 0.40 to 0.66), larger vs. smaller tumor size (OR: 1.02; 95%CI: 1.01 to 1.03) and previous/synchronous bladder cancer vs. the absence of bladder cancer (OR: 1.59; 95%CI: 1.26 to 1.9). No significant differences in IVR after RNU were found in the high vs. low age, multifocal tumors vs. single tumor, G3 vs. G1,2, high vs. low grade, N0 vs. N+, concomitant carcinoma in situ (CIS) vs. the absence of CIS, positive vs. negative lymphovascular invasion, open versus laparoscopic nephroureterectomy and endoscopic vs. transvesical technique. CONCLUSIONS our study showed that female patient, ureteral tumor, larger tumor, low T stage (Tis, a, 1) and the history of bladder cancer were significant risk factors related to IVR after nephroureterectomy. The age, tumor multifocality, G grade, lymph node status, lymphovascular invasion, Concomitant CIS, type of surgery and management of the bladder cuff were not significantly associated with the risk of IVR after nephroureterectomy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e893-e894 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Haichao Yuan More articles by this author Ping Han More articles by this author Qiang Wei More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...