Segmental Ureterectomy is Acceptable for High-risk Ureteral Carcinoma Comparing to Radical Nephroureterectomy

Segmental Ureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review and Meta-analysis of Comparative Studies

“…The SU group showed lower 5-year RFS (OR, 0.64; 95% CI, 0.43-0.95; P ¼ .03). 16,[18][19][20][21]24,26,28,29 This was confirmed in the cumulative analysis of HRs, where the RNU group was associated with higher RFS (HR, 1.26; 95% CI, 1.07-1.49; P ¼ .006). 16,21,24,29 On the other hand, there was no statistically significant difference in terms 5-year MFS and CSS (Figure 3).…”

“…Eighteen comparative studies were deemed eligible for meta-analysis. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] No randomized controlled trial was available, all the studies were retrospective, and only one was prospective. 16 All the studies included were of intermediate quality.…”

“…No statistically significant difference was found in preoperative eGFR, whereas the SU group showed higher postoperative eGFR (WMD, 10.97 mL/min; 95% CI, 2.97-18.98; P ¼ .007). 21,23,[26][27][28] Despite the fact that SU seemed to be clinically associated with an improvement of eGFR, it did not achieve the conventional level of statistical significance (WMD, 7.18 mL/min; 95%CI, À1.68 to 16.04; P ¼ .11) 20,21,23,26,29 (Table 3).…”

“…No statistically significant differences in terms of age, gender, race, smoking history, and American Society of Anesthesiologists score were recorded. More patients in the SU group had a history of bladder cancer (OR, 1.99; 95% CI, 1.12-3.51; P ¼ .02) 13,15,16,[19][20][21][22]25,26,28,30 but a lower probability of preoperative hydronephrosis (OR, 0.52; 95% CI, 0.31-0.88; P ¼ .02). 13,15,19,21,[24][25][26] A higher rate of ureteral tumor location was found in the SU group (OR, 7.54; 95% CI, 4.15-13.68; P < .00001) 18,28,30 (Table 2).…”

“…Patients in the SU group had less advanced disease, with a lower rate of pT ! 2 (OR, 0.66; 95% CI, 0.53-0.82; P ¼ .0002) [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and high-grade tumors (OR, 0.62; 95% CI, 0.50-0.78; P < .0001). [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] No statistically significant difference was recorded in terms of positive surgical margin ( Figure 2).…”