Urachal Carcinomas: A Comprehensive Systematic Review and Meta-analysis.

IF 4.5 3区 医学 Q1 UROLOGY & NEPHROLOGY
Caio Vinícius Suartz, Lucas Motta Martinez, Marcelo Henrique Lima Silvestre, Richard Dobrucki Lima, Pedro Henrique Souza Brito, Ketlyn Assunção Galhardo, Roberto Iglesias Lopes, Victor Hondo Silva Moraes, Caio Mazzonetto Teofilo Moraes, Luana Covatti, Maria Fernanda Dias Azevedo, Lucas Schenk Almeida, Debora Narumi Demitrol Setoue, Natália Doratioto Serrano Faria Braz, José Bessa, Fernando Korkes, Leonardo O Reis, Kátia Ramos Moreira Leite, William Carlos Nahas, Paul Toren, Leopoldo Alves Ribeiro-Filho
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引用次数: 0

Abstract

Objective: This systematic review and meta-analysis aim to consolidate current evidence on the diagnosis, epidemiology, and treatment of urachal carcinoma, a rare malignancy with limited data.

Materials and methods: A systematic search of PubMed/MEDLINE was conducted up to September 2024 to identify studies involving patients with urachal carcinoma, reporting clinical epidemiological characteristics, diagnostic strategies, histopathological findings, tumor staging, treatment modalities, and oncological outcomes. Extracted data were systematically synthesized, and statistical analyses, including a single-arm meta-analysis, were performed to comprehensively evaluate oncological outcomes.

Results: Our study includes 1,901 cases of urachal carcinoma from 50 studies. The findings support the oncologic advantage of en-bloc resection with umbilectomy in localized disease, demonstrating improved survival outcomes and reduced recurrence rates. In the adjuvant setting, those receiving cisplatin-based therapy presented the best response, with 65.73% with no disease progression; similarly, in the metastatic disease, cisplatin-based regimens seem to have better responses in metastatic disease. The single-arm meta-analysis estimated a 5-year overall survival rate of 51% (95% CI: 0.49-0.54). Tumor recurrence was documented in 35% of cases (95% CI: 0.25-0.45), with local recurrence occurring in 28% (95% CI: 0.18-0.38), with the average time to recurrence of 27.6 months.

Conclusion: Our study provides the most comprehensive review of urachal carcinoma to date, providing evidence to guide clinical decisions. It underscores the oncologic benefits of en-bloc resection with umbilectomy and specific chemotherapeutic regimens. Emerging alternative therapies also show potential, highlighting the need for further research to optimize patient outcomes.

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尿管癌:一项全面的系统回顾和荟萃分析。
目的:本系统综述和荟萃分析旨在巩固目前关于尿管癌的诊断、流行病学和治疗的证据,尿管癌是一种罕见的恶性肿瘤,数据有限。材料和方法:系统检索PubMed/MEDLINE,截至2024年9月,以确定涉及尿管癌患者的研究,报告临床流行病学特征、诊断策略、组织病理学结果、肿瘤分期、治疗方式和肿瘤学结果。对提取的数据进行系统综合,并进行统计分析,包括单臂荟萃分析,以全面评估肿瘤预后。结果:我们的研究包括来自50个研究的1,901例尿管癌。研究结果支持了局部疾病脐切除术整体切除的肿瘤学优势,显示出改善的生存结果和降低的复发率。在辅助治疗中,接受以顺铂为基础的治疗的患者表现出最佳反应,65.73%的患者无疾病进展;同样,在转移性疾病中,以顺铂为基础的方案似乎对转移性疾病有更好的反应。单臂meta分析估计5年总生存率为51% (95% CI: 0.49-0.54)。35%的病例肿瘤复发(95% CI: 0.25-0.45), 28%的病例局部复发(95% CI: 0.18-0.38),平均复发时间为27.6个月。结论:我们的研究提供了迄今为止最全面的尿管癌综述,为指导临床决策提供了证据。它强调了脐切除术和特定化疗方案的整体切除的肿瘤学益处。新兴的替代疗法也显示出潜力,强调需要进一步研究以优化患者的治疗效果。
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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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