AUTHOR=Ye Tao , Yang Xiaoqi , Lv Peng , Liu Haoran , Ye Zhangqun TITLE=Prognostic Value of Preoperative Hydronephrosis in Patients Undergoing Radical Nephroureterectomy for Upper Tract Urinary Carcinoma: A Systematic Review and Meta-Analysis JOURNAL=Frontiers in Oncology VOLUME=10 YEAR=2020 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.600511 DOI=10.3389/fonc.2020.600511 ISSN=2234-943X ABSTRACT=Background

Several recent publications have evaluated the prognostic value of preoperative hydronephrosis (HN) in patients with upper tract urinary carcinoma (UTUC). The aim of this meta-analysis was to explore the pooled effect of preoperative HN on the prognosis of UTUC patients treated with radical nephroureterectomy (RNU) based on current evidence.

Methods

We performed a systematic search of Pubmed, Cochrane library, and Web of Science databases from inception to June 2020. The outcomes of interest included overall survival (OS), cancer-special survival (CSS), disease-free survival (DFS), and intravesical recurrence-free survival (IVRFS).

Results

Twenty-two studies with a total of 7,542 patients satisfied the eligibility criteria and were finally included in this meta-analysis. The percent of patients with preoperative HN varied in the eligible studies, ranging from 18 to 81%. The pooled results showed that preoperative HN was significantly associated with worse OS (P = 0.004), CSS (P < 0.001), and DFS (P = 0.005), but not IVRFS (P = 0.12). No obvious publication bias was detected by Begg’s test in all the analyses.

Conclusions

The results drawn in our meta-analysis suggest that the presence of preoperative HN is associated with worse prognosis in patients treated with RNU for UTUC. Therefore, closer surveillance and more aggressive therapy may be needed for UTUC patients present with preoperative HN. Well-designed prospective studies are necessary to substantiate the prognostic value of HN in UTUC.