Intracavitary Chemotherapy after kidney-Sparing Therapy for Upper Tract Urothelial Carcinoma: A Meta-Analysis.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY Urology Journal Pub Date : 2023-12-26 DOI:10.22037/uj.v20i.7530

Hang Zhou, Yang Pan, Mingming Xu, Shangren Wang, Yuezheng Li, Xiaoqiang Liu

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Abstract

Purpose: Intracavitary chemotherapy is one of the current treatment options for kidney-sparing treatment of upper tract urothelial carcinoma (UTUC). The purpose of this meta-analysis was to assess the efficacy and safety of intracavitary perfusion.

Methods: We carefully selected publications for study from four databases (Embase, PubMed, Web of Science, and Scopus) up to January 2023. The R 4.0.4 software was used to calculate the pooled ratio and its 95% confidence intervals (95% CIs). The I2 score was used to test heterogeneity, and the funnel plot was used to estimate the publication bias.

Results: Thirty-four studies with a total of 788 patients were included in this study. The overall survival at a median follow-up of 26.3 months was 87.2% (95% CI 0.80-0.93). The cancer-specific survival at a median follow-up of 30 months was 94.1% (95% CI 0.89-0.98). At a median follow-up of 30 months, the recurrence rate of UTUC was 27.5% (95% CI 0.21-0.34). By subgroup analysis, we found that the recurrence rate in patients with T1 / Ta stage was 35.1% and CIS stage 29.0%. The recurrence rates of BCG, Mitomycin C, and Mitomycin Gel (UGN101) were 31.2%, 41.3% and 12.9%, respectively. The recurrence rates for anterograde and retrograde perfusion were 28.5% and 21.8%, respectively.

Conclusion: With the advent of new drugs, including UGN101, patients with UTUC have a better prognosis. Therefore, kidney preservation therapy for patients with UTUC would be promising.

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上尿路尿路癌保肾治疗后的腔内化疗：一项 Meta 分析。

目的：腔内化疗是目前治疗上尿路上皮癌（UTUC）的保肾治疗方案之一。本荟萃分析旨在评估腔内灌注的有效性和安全性：我们从四个数据库（Embase、PubMed、Web of Science 和 Scopus）中精心挑选了截至 2023 年 1 月的文献进行研究。使用 R 4.0.4 软件计算汇集比值及其 95% 置信区间 (95%CI)。I2评分用于检验异质性，漏斗图用于估计发表偏倚：本研究共纳入34项研究，共计788名患者。中位随访26.3个月的总生存率为87.2%（95% CI 0.80-0.93）。中位随访30个月后的癌症特异性生存率为94.1%（95% CI 0.89-0.98）。中位随访30个月时，UTUC的复发率为27.5%（95% CI 0.21-0.34）。通过亚组分析，我们发现T1/Ta期患者的复发率为35.1%，CIS期患者的复发率为29.0%。卡介苗、丝裂霉素 C 和丝裂霉素凝胶（UGN101）的复发率分别为 31.2%、41.3% 和 12.9%。顺行灌注和逆行灌注的复发率分别为28.5%和21.8%：结论：随着 UGN101 等新药的出现，UTUC 患者的预后较好。结论：随着包括 UGN101 在内的新药的出现，UTUC 患者的预后较好，因此，UTUC 患者的保肾治疗将大有可为。

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来源期刊

Urology Journal UROLOGY & NEPHROLOGY-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

6-12 weeks

期刊介绍： As the official journal of the Urology and Nephrology Research Center (UNRC) and the Iranian Urological Association (IUA), Urology Journal is a comprehensive digest of useful information on modern urology. Emphasis is on practical information that reflects the latest diagnostic and treatment techniques. Our objectives are to provide an exceptional source of current and clinically relevant research in the discipline of urology, to reflect the scientific work and progress of our colleagues, and to present the articles in a logical, timely, and concise format that meets the diverse needs of today’s urologist. Urology Journal publishes manuscripts on urology and kidney transplantation, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. Accordingly, original articles, case reports, and letters to editor are encouraged.