Dataset Information

Prognostic significance of lymphovascular invasion in radical cystectomy on patients with bladder cancer: a systematic review and meta-analysis.

ABSTRACT:

Purpose

The objective of the present study was to conduct a systematic review and meta-analysis of published literature to appraise the prognostic value of lymphovascular invasion (LVI) in radical cystectomy specimens.

Materials and methods

Following the PRISMA statement, PubMed, Cochrane Library, and SCOPUS database were searched from the respective dates of inception until June 2013.

Results

A total of 21 articles met the eligibility criteria for this systematic review, which included a total of 12,527 patients ranging from 57 to 4,257 per study. LVI was detected in 34.6% in radical cystectomy specimens. LVI was associated with higher pathological T stage and tumor grade, as well as lymph node metastasis. The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (pooled HR, 1.61; 95% confidence interval [CI], 1.26-2.06), cancer-specific survival (pooled HR, 1.67; 95% CI, 1.38-2.01), and overall survival (pooled HR, 1.67; 95% CI, 1.38-2.01), despite the heterogeneity among included studies. On sensitivity analysis, the pooled HRs and 95% CIs were not significantly altered when any one study was omitted. The funnel plot for overall survival demonstrated a certain degree of asymmetry, which showed slight publication bias.

Conclusions

This meta-analysis indicates that LVI is significantly associated with poor outcome in patients with bladder cancer who underwent radical cystectomy. Adequately designed prospective studies are required to provide the precise prognostic significance of LVI in bladder cancer.

SUBMITTER: Kim H

PROVIDER: S-EPMC3931717 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Prognostic significance of lymphovascular invasion in radical cystectomy on patients with bladder cancer: a systematic review and meta-analysis.

Kim Hwanik H Kim Myong M Kwak Cheol C Kim Hyeon Hoe HH Ku Ja Hyeon JH

PloS one 20140221 2

<h4>Purpose</h4>The objective of the present study was to conduct a systematic review and meta-analysis of published literature to appraise the prognostic value of lymphovascular invasion (LVI) in radical cystectomy specimens.<h4>Materials and methods</h4>Following the PRISMA statement, PubMed, Cochrane Library, and SCOPUS database were searched from the respective dates of inception until June 2013.<h4>Results</h4>A total of 21 articles met the eligibility criteria for this systematic review, w ...[more]

PMID: 24586637

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Project description:Background and objectiveMore recently laparoscopic radical cystectomy (LRC) has increasingly been an attractive alternative to open radical cystectomy (ORC) and many centers have reported their early experiences in the treatment of bladder cancer. Evaluate the safety and efficacy of LRC compared with ORC in the treatment of bladder cancer.MethodsA systematic search of Medline, Scopus, and the Cochrane Library was performed up to Mar 1, 2013. Outcomes of interest assessing the two techniques included demographic and clinical baseline characteristics, perioperative, pathologic and oncological variables, and post-op neobladder function and complications.ResultsSixteen eligible trials evaluating LRC vs ORC were identified including seven prospective and nine retrospective studies. Although LRC was associated with longer operative time (p<0.001), patients might benefit from significantly fewer overall complications (p<0.001), less blood loss (p<0.001), shorter length of hospital stay (p<0.001), less need of blood transfusion (p<0.001), less narcotic analgesic requirement (p<0.001), shorter time to ambulation (p = 0.03), shorter time to regular diet (p<0.001), fewer positive surgical margins (p = 0.006), fewer positive lymph node (p = 0.05), lower distant metastasis rate (p = 0.05) and fewer death (p = 0.004). There was no significant difference in other demographic parameters except for a lower ASA score (p = 0.01) in LRC while post-op neobladder function were similar between the two groups.ConclusionsOur data suggest that LRC appears to be a safe, feasible and minimally invasive alternative to ORC with reliable perioperative safety, pathologic & oncologic efficacy, comparable post-op neobladder function and fewer complications. Because of the inherent limitations of the included studies, further large sample prospective, multi-centric, long-term follow-up studies and randomized control trials should be undertaken to confirm our findings.

Project description:BackgroundAssessing the prognostic significance of specific clinicopathological features plays an important role in surgical management after radical cystectomy. This study investigated the association between ten clinicopathological characteristics and cancer-specific survival (CSS) in patients with bladder cancer.MethodsIn accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a literature search was conducted through the PubMed, EMBASE and Web of Science databases using appropriate search terms from the dates of inception until November 2018. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to evaluate the CSS. Fixed- or random-effects models were constructed according to existence of heterogeneity.ResultsThirty-three articles met the eligibility criteria for this systematic review, which included 19,702 patients. The overall results revealed that CSS was associated with advanced age (old vs. young: pooled HR?=?1.01; 95% CI:1.00-1.01; P?<?0.001), higher tumor grade (3 vs. 1/2: pooled HR?=?1.29; 95% CI:1.15-1.45; P?<?0.001), higher pathological stage (3/4 vs. 1/2: pooled HR?=?1.60; 95% CI:1.37-1.86; P?<?0.001), lymph node metastasis (positive vs. negative: pooled HR?=?1.51; 95% CI:1.37-1.67; P?<?0.001), lymphovascular invasion (positive vs. negative: pooled HR?=?1.36; 95% CI:1.28-1.45; P?<?0.001), and soft tissue surgical margin (positive vs. negative: pooled HR?=?1.42; 95% CI:1.30-1.56; P?<?0.001). However, gender (male vs. female: pooled HR?=?0.98; 95% CI: 0.96-1.01; P?=?0.278), carcinoma in situ (positive vs. negative: pooled HR?=?0.98; 95% CI: 0.88-1.10; P?=?0.753), histology (transitional cell cancer vs variant: pooled HR?=?0.90; 95% CI: 0.79-1.02; P?=?0.089) and adjuvant chemotherapy (yes vs. no: pooled HR?=?1.16; 95% CI: 1.00-1.34; P?=?0.054) did not affect CSS after radical resection of bladder cancer.ConclusionsOur results revealed that several clinicopathological characteristics can predict CSS risk after radical cystectomy. Prospective studies are needed to further confirm the predictive value of these variables for the prognosis of bladder cancer patients after radical cystectomy.

Dataset Information

Prognostic significance of lymphovascular invasion in radical cystectomy on patients with bladder cancer: a systematic review and meta-analysis.

Purpose

Materials and methods

Results

Conclusions

Publications

Prognostic significance of lymphovascular invasion in radical cystectomy on patients with bladder cancer: a systematic review and meta-analysis.

Similar Datasets

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