Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review.

IF 4.3 2区医学 Q2 ONCOLOGY

Therapeutic Advances in Medical Oncology Pub Date : 2024-11-16 eCollection Date: 2024-01-01 DOI:10.1177/17588359241298470

Qing-Xin Yu, Rui-Cheng Wu, Zhou-Ting Tuo, Wei-Zhen Zhu, Jie Wang, Xing Ye, Koo Han Yoo, Wu-Ran Wei, De-Chao Feng, Deng-Xiong Li

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引用次数: 0

Abstract

Background: Repeat transurethral resection of bladder tumour (reTURB) is a conventional treatment for non-muscle-invasive bladder cancer (NMIBC) to enhance prognosis. However, the necessity of reTURB in NMIBC remains controversial owing to upstaging of treatments and new evidence.

Objectives: We performed an umbrella review to determine the need for reTURB in patients with NMIBC.

Design: We extracted data from meta-analyses that were screened out after a systematic search of PubMed, Embase, the Web of Science and the Cochrane Database of Systematic Reviews.

Methods: Risk of Bias in Systematic Reviews and the Grading of Recommendations, Assessment, Development and Evaluation tools were used to assess the quality of each included meta-analysis and outcomes.

Results: Our study included seven meta-analyses. Two studies assessed the efficiency of reTURB in patients who underwent en bloc resection of bladder tumours (ERBT). Patients who underwent ERBT reported low residual tumour and upstaging rates of 5.9% and 0.3%, respectively. Conversely, patients who underwent conventional transurethral resection for bladder cancer (cTURB) had high residual tumour rates. Patients who underwent cTURB and reTURB had significantly improved 1-year recurrence-free survival (RFS) compared to those who underwent initial cTURB alone. In terms of progression-free survival (PFS), a meta-analysis reported that patients who underwent cTURB and reTURB had significantly improved PFS compared with those who underwent initial cTURB alone. In the subgroup analyses of ERBT, reTURB did not affect the RFS and PFS of patients who received ERBT. Currently, only a limited number of randomised clinical trials have evaluated reTURB, and various factors have influenced its efficacy.

Conclusion: There was significant variation in survival outcomes among patients undergoing reTURB. The necessity and efficacy of reTURB depend on numerous factors, such as surgical approach, equipment and medication usage. Patients eligible for ERBT may constitute a group that does not require reTURB. Further clinical trials are required to validate these findings.

Registration: This umbrella review was registered with the International Prospective Register of Systematic Reviews (CRD42023439078).

查看原文本刊更多论文

重复经尿道切除术在无肌肉浸润性膀胱肿瘤中的作用：综述。

背景：重复经尿道膀胱肿瘤切除术（reTURB）是非肌层浸润性膀胱癌（NMIBC）的常规治疗方法，可改善预后。然而，由于治疗方法的升级和新证据的出现，NMIBC 是否有必要再次进行尿道前列腺切除术仍存在争议：我们进行了一项综述，以确定 NMIBC 患者是否有必要再次进行 TURB：我们从PubMed、Embase、Web of Science和Cochrane系统综述数据库的系统检索后筛选出的荟萃分析中提取了数据：方法：采用 "系统综述中的偏倚风险 "和 "推荐、评估、发展和评价分级 "工具来评估每项纳入的荟萃分析和结果的质量：我们的研究包括七项荟萃分析。其中两项研究评估了对接受膀胱肿瘤全切术（ERBT）的患者进行reTURB的效率。接受ERBT的患者报告的肿瘤残留率和上行分期率较低，分别为5.9%和0.3%。相反，接受传统经尿道膀胱癌切除术（cTURB）的患者肿瘤残留率较高。接受经尿道膀胱癌切除术（cTURB）和再经尿道膀胱癌切除术（reTURB）的患者的1年无复发生存期（RFS）比仅接受初次经尿道膀胱癌切除术（cTURB）的患者明显提高。在无进展生存期（PFS）方面，一项荟萃分析报告显示，接受 cTURB 和 reTURB 治疗的患者与单纯接受初始 cTURB 治疗的患者相比，PFS 有明显改善。在 ERBT 的亚组分析中，reTURB 对接受 ERBT 的患者的 RFS 和 PFS 没有影响。目前，只有为数不多的随机临床试验对reTURB进行了评估，影响其疗效的因素多种多样：结论：接受再行前列腺癌根治术的患者的生存结果存在明显差异。再行前列腺切除术的必要性和疗效取决于多种因素，如手术方法、设备和药物使用。符合ERBT条件的患者可能是不需要再行TURB的群体。需要进一步的临床试验来验证这些发现：本综述已在国际系统综述前瞻性注册中心注册（CRD42023439078）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Medical Oncology ONCOLOGY-

CiteScore

8.20

自引率

2.00%

发文量

160

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).