Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis
BackgroundThis study aims to evaluate the effectiveness of en bloc resection for patients with nonmuscle invasive bladder cancer (NMIBC) and explore whether a reresection can be avoided after initial en bloc resection.Material and methodsWe conducted research in PubMed, EMBASE, Cochrane Library, and...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.849929/full |
| _version_ | 1797995090990333952 |
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| author | Jiangnan Xu Jiangnan Xu Zhenyu Xu HuMin Yin Jin Zang |
| author_facet | Jiangnan Xu Jiangnan Xu Zhenyu Xu HuMin Yin Jin Zang |
| author_sort | Jiangnan Xu |
| collection | DOAJ |
| description | BackgroundThis study aims to evaluate the effectiveness of en bloc resection for patients with nonmuscle invasive bladder cancer (NMIBC) and explore whether a reresection can be avoided after initial en bloc resection.Material and methodsWe conducted research in PubMed, EMBASE, Cochrane Library, and Web of Science up to October 12, 2021, to identify studies on the second resection after initial en bloc resection of bladder tumor (ERBT). R software and the double arcsine method were used for data conversion and combined calculation of the incidence rate.ResultsA total of 8 studies involving 414 participants were included. The rate of detrusor muscle in the ERBT specimens was 100% (95%CI: 100%–100%), the rate of tumor residual in reresection specimens was 3.2% (95%CI: 1.4%–5.5%), and the rate of tumor upstaging was 0.3% (95%CI: 0%–1.5%). Two articles compared the prognostic data of the reresection and non-reresection groups after the initial ERBT. We found no significant difference in the 1-year recurrence-free survival (RFS) rate (OR = 1.44, 95%CI: 0.67–3.09, P = 0.35) between the two groups nor in the rate of tumor recurrence (OR = 0.72, 95%CI: 0.44–1.18, P = 0.2) or progression (OR = 0.98, 95%CI: 0.33–2.89, P = 0.97) at the final follow-up.ConclusionsERBT can almost completely remove the detrusor muscle of the tumor bed with a very low postoperative tumor residue and upstaging rate. For high-risk NMIBC patients, an attempt to appropriately reduce the use of reresection after ERBT seems to be possible. |
| first_indexed | 2024-04-11T09:56:00Z |
| format | Article |
| id | doaj.art-209d361ee1a142efbaa27268acc4b7fc |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T09:56:00Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-209d361ee1a142efbaa27268acc4b7fc2022-12-22T04:30:37ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-09-01910.3389/fsurg.2022.849929849929Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysisJiangnan Xu0Jiangnan Xu1Zhenyu Xu2HuMin Yin3Jin Zang4Department of Urology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, Yancheng, ChinaDepartment of Urology, The First People’s Hospital of Yancheng, Yancheng, ChinaDepartment of Urology, Kunshan Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, ChinaDepartment of Urology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Urology, The First Affiliated Hospital of Soochow University, Suzhou, ChinaBackgroundThis study aims to evaluate the effectiveness of en bloc resection for patients with nonmuscle invasive bladder cancer (NMIBC) and explore whether a reresection can be avoided after initial en bloc resection.Material and methodsWe conducted research in PubMed, EMBASE, Cochrane Library, and Web of Science up to October 12, 2021, to identify studies on the second resection after initial en bloc resection of bladder tumor (ERBT). R software and the double arcsine method were used for data conversion and combined calculation of the incidence rate.ResultsA total of 8 studies involving 414 participants were included. The rate of detrusor muscle in the ERBT specimens was 100% (95%CI: 100%–100%), the rate of tumor residual in reresection specimens was 3.2% (95%CI: 1.4%–5.5%), and the rate of tumor upstaging was 0.3% (95%CI: 0%–1.5%). Two articles compared the prognostic data of the reresection and non-reresection groups after the initial ERBT. We found no significant difference in the 1-year recurrence-free survival (RFS) rate (OR = 1.44, 95%CI: 0.67–3.09, P = 0.35) between the two groups nor in the rate of tumor recurrence (OR = 0.72, 95%CI: 0.44–1.18, P = 0.2) or progression (OR = 0.98, 95%CI: 0.33–2.89, P = 0.97) at the final follow-up.ConclusionsERBT can almost completely remove the detrusor muscle of the tumor bed with a very low postoperative tumor residue and upstaging rate. For high-risk NMIBC patients, an attempt to appropriately reduce the use of reresection after ERBT seems to be possible.https://www.frontiersin.org/articles/10.3389/fsurg.2022.849929/fullhigh-risknonmuscle-invasive bladder canceren bloc resectionreresectionsystematic review and meta-analysis |
| spellingShingle | Jiangnan Xu Jiangnan Xu Zhenyu Xu HuMin Yin Jin Zang Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis Frontiers in Surgery high-risk nonmuscle-invasive bladder cancer en bloc resection reresection systematic review and meta-analysis |
| title | Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis |
| title_full | Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis |
| title_fullStr | Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis |
| title_full_unstemmed | Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis |
| title_short | Can a reresection be avoided after initial en bloc resection for high-risk nonmuscle invasive bladder cancer? A systematic review and meta-analysis |
| title_sort | can a reresection be avoided after initial en bloc resection for high risk nonmuscle invasive bladder cancer a systematic review and meta analysis |
| topic | high-risk nonmuscle-invasive bladder cancer en bloc resection reresection systematic review and meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.849929/full |
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