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A Systematic Review and Meta-analysis of clinicopathologic factors predicting upper urinary tract recurrence after radical cystectomy for urothelial bladder cancer

  • Mehdi Kardoust Parizi
    Affiliations
    Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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  • Vitaly Margulis
    Affiliations
    Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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  • Yair Lotan
    Affiliations
    Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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  • Abdulmajeed Aydh
    Affiliations
    Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Department of Urology, King Faisal Medical City, Abha, Saudi Arabia
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  • Shahrokh F. Shariat
    Correspondence
    Corresponding author: Shahrokh F. Shariat. Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Tel: +4314040026150 Fax: +4314040023320
    Affiliations
    Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Departments of Urology, Weill Cornell Medical College, New York, New York, USA

    Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic

    Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
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Published:November 12, 2022DOI:https://doi.org/10.1016/j.clgc.2022.11.002

      Abstract

      Objective

      To identify risk factors for upper urinary tract recurrence (UUTR) in patients treated with radical cystectomy (RC) for urothelial bladder carcinoma (UBC).

      Methods

      The PubMed, Web of Science, and Cochrane Library were searched on March 2022 to identify relevant studies according to the Preferred Reporting Items for Systematic Review (PRISMA) statement. We included studies that provided multivariate logistic regression analyses. The pooled UUTR rate was calculated using a fixed effect model.

      Results

      We identified 235 papers, of which seven and six articles, comprising a total of 8981 and 8404 UBC patients, were selected for qualitative and quantitative analyses, respectively. Overall, 418 (4.65%) patients were diagnosed with UUTR within a median time of 1.4 to 3.1 years after RC. Risk factors for UUTR were surgical margin (hazard ratio [HR] 3.41, 95% confidence interval [CI] 2.59-4.49, p<0.00001), preoperative hydronephrosis (HR: 1.74, 95% CI: 1.25-2.43, p=0.001), ureteral margin (HR: 4.34, 95% CI: 2.75-6.85, p<0.00001), and pT stage (HR: 2.69, 95% CI: 1.37-5.27, p<0.004).

      Conclusions

      : Incorporation of established risk factors into a clinical prediction model might aid in the decision-making process regarding the intensity and type of surveillance protocols after RC as well as help determine the pretest probability of UUTR.

      Keywords

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