Correlation Between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer

Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma Increased the Risk of Intravesical Recurrence

“…However, some scientists noted that the URS procedure and associated manipulation may increase the risk of intraluminal tumor seeding and IVR. Several studies have focused on analysing the outcome of bladder tumor recurrence, but the impact of URS on IVR after RNU remained controversial [8-17]. Thus, this meta-analysis was performed to further explore whether diagnostic URS could increase the risk of IVR following RNU in patients with UTUC.…”

“…As shown in Figure 1, we retrieved 11 studies [8-17] eligible for this systematic review and meta-analysis. The general descriptions of included studies were summarised in Table 1.…”

“…The general descriptions of included studies were summarised in Table 1. Among the included studies, 7 (60%) were from Asian countries [8, 10, 11, 13, 14, 17] and 3 studies were conducted in USA [9, 15, 16] and one in France [12], respectively. A total of 4,057 participants were included in the subsequent meta-analysis, of which 518 patients had a history of TCC in bladder.…”

“…Eight studies [8-11, 13, 14, 17, 24] provided HRs for the URS-related risk of IVR, including 3,340 participants, of which 1,219 had IVR. The reasons to exclude the other 3 studies from quantitative analysis included no HR available [16] and HRs were for URS-related risk of recurrence (both upper tract and IVR) [12, 15].…”

“…For studies that had not shown the corresponding results, the Engauge Digitizer v.4.1 software was used to extract survival data from the Kaplan-Meier curves [18, 20]. One study [17] reported stratified risk estimates by timing of RNU after URS, immediately or later (median 5 days), and we combined these estimates using a random-effects model and then used the pooled estimates for the meta-analysis [21]. …”