A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma.

@article{Seisen2015ASR,
  title={A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma.},
  author={T. Seisen and B. Granger and P. Colin and P. L{\'e}on and G. Utard and R. Renard-Penna and E. Comp{\'e}rat and P. Mozer and O. Cussenot and S. Shariat and M. Roupr{\^e}t},
  journal={European urology},
  year={2015},
  volume={67 6},
  pages={
          1122-1133
        }
}
CONTEXT There is an ongoing debate about the factors that influence intravesical recurrence (IVR) after radical nephrouretectomy (RNU) to treat upper tract urothelial carcinoma (UTUC). OBJECTIVE To assess significant predictors of IVR after RNU from a systematic review of the literature and meta-analysis. EVIDENCE ACQUISITION A computerized bibliographic search of the Medline, Embase, and Cochrane databases was performed for all reports that included detailed results of multivariate… Expand
Intravesical Chemotherapy after Radical Nephroureterectomy for Primary Upper Tract Urothelial Carcinoma: A Systematic Review and Network Meta-Analysis
TLDR
It is demonstrated that intravesical chemotherapy can prevent bladder recurrence in patients with upper tract urothelial carcinoma after nephroureterectomy and it is suggested that a single instillation of pirarubicin is the most efficacious intravesicals regimen. Expand
The impact of diagnostic ureteroscopy prior to radical nephroureterectomy on oncological outcomes in patients with upper tract urothelial carcinoma: a comprehensive systematic review and meta-analysis
Background: The incidence of intravesical recurrence (IVR) following radical nephroureterectomy (RNU) is reported in up to 50% of patients with upper tract urothelial carcinoma (UTUC). It wasExpand
Impact of diagnostic ureteroscopy on intravesical recurrence in patients undergoing radical nephroureterectomy for upper tract urothelial cancer: a systematic review and meta‐analysis
TLDR
Findings suggest a significant association between the use of diagnostic URS and higher risk of developing IVR after RNU in patients undergoing radical nephroureterectomy for high‐risk upper tract urothelial carcinoma. Expand
A systematic review and meta-analysis of oncological and renal function outcomes obtained after segmental ureterectomy versus radical nephroureterectomy for upper tract urothelial carcinoma.
  • D. Fang, T. Seisen, +7 authors L. Zhou
  • Medicine
  • European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • 2016
TLDR
Although adverse patient and tumor characteristics were not equally balanced between treatment arms, the systematic review and meta-analysis supports similar oncological outcomes between SU and RNU, with better preservation of renal function after SU. Expand
Prognostic Value of Variant Histology in Upper Tract Urothelial Carcinoma Treated with Nephroureterectomy: A Systematic Review and Meta-Analysis.
TLDR
Variant histology in patients with UTUC is associated with an increased risk of cancer-specific mortality, overall mortality, and disease recurrence, and it might be useful to incorporate variant histology into prognostic tools that help patients and physicians in selecting appropriate treatment strategies for UTUC. Expand
Long-term oncologic outcomes of laparoscopic nephroureterectomy versus open nephroureterectomy for upper tract urothelial carcinoma: a systematic review and meta-analysis
TLDR
Based on current evidence, LNU could provide equivalent prognostic effects for upper tract urothelial carcinoma, and had better oncological control of ExRFS and CSS compared to ONU, and should be interpreted with caution. Expand
Kidney-sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Systematic Review and Meta-analysis.
TLDR
On the whole, kidney-sparing management had equivalent prognostic effect on upper tract urothelial carcinoma as the standard nephroureterectomy except in tumor recurrence. Expand
Synchronous and metachronous urothelial carcinoma of the upper urinary tract and the bladder: Are they clonally related? A systematic review.
TLDR
Taking into account the limitations of microsatellite technology in comparison to Next Generation Sequencing and currently accepted concepts of tumor heterogeneity and evolution, this systematic review shows that most, if not all, UTUC and paired UCB likely are clonally related. Expand
Prognostic value of preoperative blood-based biomarkers in upper tract urothelial carcinoma treated with nephroureterectomy: A systematic review and meta-analysis.
TLDR
Blood-based biomarkers may have the potential to serve as prognostic factors to assist patients and physicians in selecting appropriate treatment strategies for UTUC, but considering the study limitations including heterogeneity and retrospective nature of the primary data, the conclusions should be interpreted with caution. Expand
Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma Increased the Risk of Intravesical Recurrence
TLDR
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. Expand
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In the current study, intravesical recurrence occurred in 35 % of patients with UTUC after RNU and previous history of bladder cancer, tumor multifocality, concomitant CIS and laparoscopic approach were independent predictors of intravesicals recurrence. Expand
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A nomogram for prediction of the probability of intravesical recurrence at 3, 6, 9, 12, 18, 24, and 36 mo is developed and could improve the clinical decision-making process with regard to cystoscopic surveillance scheduling and postoperative intravesicals instillations of MMC after RNU. Expand
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Lower tumor grade, tumor multifocality, concomitant CIS and tumors located in the lower ureter tend to be predictive for bladder recurrence after nephroureterectomy, although the underlying mechanism is not fully elucidated, and the scoring system could help risk stratification. Expand
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TLDR
Intravesical instillation of pirarubicin immediately after nephroureterectomy significantly reduced the bladder recurrence rate in patients with positive voided urine cytology, suggesting that intravesical seeding of upper urinary tract urothelial carcinoma occurs during nephroretrectomy. Expand
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TLDR
Interestingly, concomitant CIS in the upper tract is a strong predictor of intravesical recurrence after RNU, and the association of laparoscopic RNU with intravesicals recurrence needs to be further investigated. Expand
Intravesical Recurrence after Surgical Management of Urothelial Carcinoma of the Upper Urinary Tract
TLDR
Tumor multifocality is a significant risk factor in developing IVR after surgery for UUT-UC, and it is necessary to follow such patients more closely using cystoscopy, however, IVR is unlikely to indicate a poorer prognosis. Expand
Surgical management of the distal ureter during radical nephroureterectomy is an independent predictor of oncological outcomes: results of a current series and a review of the literature.
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Surgical management of the distal ureter without excision of a TVBC resulted in significantly worse non-IVR FS and CSS but had no influence on IVR, which supports further prospective study as to standardization of BC resection during RNU. Expand
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TLDR
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