|
|||||
|
|
Oncological impact of cystoscopic findings in non-muscle-invasive bladder cancer: a meta-analysis |
|
| Authors: | Takafumi Yanagisawa Fahad Quhal Tatsushi Kawada Hadi Mostafaei Reza Sari Motlagh Ekaterina Laukhtina Pawel Rajwa Markus von Deimling Alberto Bianchi Maximilian Pallauf Muhammad Majdoub Benjamin Pradere Mohammad Abufaraj Marco Moschini Pierre I. Karakiewicz Kosuke Iwatani Jun Miki Takahiro Kimura Shahrokh F. Shariat |
| Affiliation: | 1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;2. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy;3. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria Department of Urology, Hillel Yaffe Medical Center, Hadera, Israel;4. Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan;5. Department of Urology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy;6. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada;7. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan |
| Abstract: | ObjectiveTo assess the association between cystoscopic findings and oncological outcomes in patients with non-muscle-invasive bladder cancer (NMIBC) given that the oncological impact of quantity and quality assessment of tumours with cystoscopy has not been well verified.MethodsMultiple databases were queried in May 2022 for studies investigating the association of oncological outcomes, such as recurrence-free (RFS), progression-free (PFS), and cancer-specific survival (CSS), with cystoscopic findings, including multiplicity, size, and gross appearance of tumours in patients with NMIBC.ResultsOverall, 73 studies comprising 28 139 patients were eligible for the meta-analysis. Tumour multiplicity was associated with worse RFS (pooled hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.48–1.74) and PFS (pooled HR 1.44, 95% CI 1.18–1.76) in NMIBC patients (including both Ta and T1). Tumour size (≥3 cm) was associated with worse RFS (pooled HR 1.97, 95% CI 1.69–2.30) and PFS (pooled HR 1.81, 95% CI 1.52–2.15) in NMIBC patients. In patients with T1 bladder cancer (BCa), tumour multiplicity and size (≥3 cm) were also associated with worse RFS, PFS and CSS. By contrast, among patients treated with bacillus Calmette-Guérin (BCG), tumour multiplicity was not associated with worse RFS, and tumour size (≥3 cm) was not associated with worse PFS. Sessile tumours were associated with worse RFS (pooled HR 2.14, 95% CI 1.52–3.01) and PFS (pooled HR 2.17, 95% CI 1.42–3.32) compared to pedunculated tumours. Compared to papillary tumours, solid tumours were associated with worse RFS (pooled HR 1.84, 95% CI 1.25–2.72) and PFS (pooled HR 3.06, 95% CI 2.31–4.07) in NMIBC patients, and CSS in T1 BCa patients (pooled HR 2.32, 95% CI 1.63–3.30).ConclusionsCystoscopic findings, including tumour multiplicity, size, and gross appearance, strongly predict oncological outcomes in NMIBC patients. Cystoscopic visual features can help in the decision-making process regarding the timeliness and extent of tumour resection as well as future management such as intravesical therapy. |
| Keywords: | non-muscle-invasive bladder cancer cystoscopy multiplicity size gross appearance recurrence progression #BladderCancer #blcsm #uroonc |