[1]张驌,王诚,翟振兴,等.上尿路尿路上皮肿瘤根治术前输尿管镜检查对远期预后影响的Meta分析[J].第三军医大学学报,2017,39(01):101-106.
 Zhang Su,Wang Cheng,Zhai Zhenxing,et al.Long-term effect of ureteroscopy prior to radical nephroureterectomy for upper tract urothelial carcinoma: a meta-analysis[J].J Third Mil Med Univ,2017,39(01):101-106.
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上尿路尿路上皮肿瘤根治术前输尿管镜检查对远期预后影响的Meta分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第01期
页码:
101-106
栏目:
公共卫生与预防医学
出版日期:
2017-01-15

文章信息/Info

Title:
Long-term effect of ureteroscopy prior to radical nephroureterectomy for upper tract urothelial carcinoma: a meta-analysis
作者:
张驌王诚翟振兴王娟牛纪平付生军王新平杨立
兰州大学泌尿外科研究所,兰州大学第二医院泌尿外科,甘肃省泌尿系统疾病临床医学中心,甘肃省泌尿系统疾病研究重点实验室
Author(s):
Zhang Su Wang Cheng Zhai Zhenxing Wang Juan Niu Jiping Fu Shengjun Wang Xinping Yang Li

Department of Urology, Lanzhou University Institute of Urology, Gansu NephronUrological Clinical Center, Gansu Provincial Key Laboratory of Urological System Diseases, Second Hospital of Lanzhou University, Lanzhou, Gansu Province, 730030, China

Keywords:
upper tract urothelial carcinoma ureteroscopy prognosis
分类号:
R181.23; R730.49; R737.13
文献标志码:
A
摘要:

目的      Meta分析上尿路尿路上皮肿瘤(upper tract urothelial carcinoma, UTUC)根治手术前行输尿管镜检查(ureteroscopy, URS)对UTUC远期预后的影响。方法      计算机检索PubMed、EMbase、Cochrane Library、中国生物医学文献数据库、万方、维普和中国知网数据库,收集URS对UTUC预后影响的前瞻性或回顾性研究,检索时限为建库至2016年2月29日。由两名研究者按照纳入与排除标准进行文献纳入,对纳入的研究行质量评价,提取相关肿瘤预后资料风险比(hazard ratios,HR)及其95%可信区间(confidence interval, CI),采用Stata 12软件进行Meta分析。结果      共纳入13个回顾性研究,包括4 105例患者。Meta分析结果显示:术前行URS未增加疾病无复发生存风险,单因素合并结果[HR=0.93, 95%CI(0.73, 1.13)],多因素合并结果[HR=1.13, 95%CI(0.90, 1.36)];行URS未增加膀胱内无复发生存风险,单因素合并结果[HR=1.13, 95% CI(0.82, 1.43)],多因素合并结果[HR=1.54, 95%CI(0.97, 2.12)];对于肿瘤特异生存期,单因素合并结果显示行URS组优于未行URS组[HR=0.68, 95%CI(0.48, 0.88)],而多因素合并结果两者差异无统计学意义[HR=0.83, 95%CI(0.54, 1.12)];行URS未增加总体生存风险,单因素合并结果差异无统计学意义[HR=0.87, 95%CI(0.46, 1.27)]。结论       术前行URS并未影响UTUC患者术后远期肿瘤复发及生存情况。

Abstract:

Objective      To determine the effect of ureteroscopy (URS) prior to radical nephroureterectomy on the long-term prognosis in treatment of upper tract urothelial carcinoma (UTUC). Methods      Computer retrieval was carried out in PubMed, EMBase, Cochrane library, China Biology Medicine disc (CBM), WanFang Data, VIP database, and China National Knowledge Infrastructure (CNKI) from establishment until February 29, 2016 for prospective or retrospective studies on the effect of URS on the prognosis of UTUC. All the collected researches were analyzed by 2 reviewers independently according to our inclusion and exclusion criteria. The quality of the literature was assessed, and the extracted data was systematically analyzed for corresponding hazard ratios (HR) and 95% confidence interval (95%CI) by using Stata 12. Results      Thirteen retrospective studies were eligible, including 4 105 patients. The pooled HR of recurrencefree survival (RFS) was not significant in the univariate analysis (HR=0.93, 95%CI: 0.73~1.13) or the multivariate analysis  (HR=1.13, 95%CI: 0.90~1.36). The pooled HR of intravesical recurrence-free survival (IRFS) was HR=1.13, 95%CI: 0.82~1.43 in the univariate analysis and HR=1.54, 95%CI: 0.97~2.12 in the multivariate analysis. The pooled HR of cancer specific survival (CSS) was significant in the univariate analysis (HR=0.68, 95%CI: 0.48~0.88), but not in the multivariate analysis  (HR=0.83, 95%CI: 0.54~1.12). The pooled HR of overall survival (OS) was not significant in the univariate  (HR=0.87, 95%CI: 0.46~1.27). Conclusion      Based on our meta-analysis of current evidence, the performance of URS prior to radical nephroureterectomy for UTUC has no adverse effect on longterm recurrence and survival.

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更新日期/Last Update: 2017-01-03