Kidney-sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Systematic Review and Meta-analysis.

摘要: Purpose: To evaluate and update evidence for prognostic effects of kidney-sparing (KS) management nephroureterectomy (NU) upper tract urothelial carcinomas. Materials Methods: Pubmed, Embase the Cochrane Library were retrieved identification comparative studies procedure carcinoma prior to December 2014. The data extracted independently by 2 reviewers quality included was assessed. Review Manager 5.3 STATA 13 used perform meta-analysis. Results: Twenty-three observational including 1,587 KS 3,996 NU evaluated. results meta-analysis showed that had no significant benefit with regard intravesical recurrence (IRFS), metastasis (MFS), cancer specific survival (CSS) overall (OS) except total tumor (RFS) when compared kidney sparing management. respectively pooled outcomes HR 1.36 (0.69-2.68, P=0.38) IRFS, 1.09 (0.59-2.01, P=0.78) MFS, 1.17 (0.77-1.79, P=0.47) CSS, 1.50 (0.90-2.48, P=0.12) OS 1.61 (1.03-2.51, P=0.04) RFS. Conclusions: On whole, equivalent effect on as standard in recurrence. However, should be interpreted caution lack stage grade stratification multi-center randomized controlled trials are still needed verify our results.