AUTHOR=Liu Yang , Zhang Huimin , Wen Zhi , Jiang Yu , Huang Jing , Wang Chongjian , Chen Caixia , Wang Jiahao , Bao Erhao , Yang Xuesong 

TITLE=Simultaneous radical cystectomy and nephroureterectomy in the treatment of panurothelial carcinoma: a systematic review and single-arm meta-analysis

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1233125

DOI=10.3389/fonc.2023.1233125

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Panurothelial carcinoma is a rare and aggressive malignancy that requires effective treatment strategies to enhance patient outcomes.</p></sec><sec><title>Methods</title><p>We conducted a systematic search of English publications in databases including PubMed, Embase, Cochrane Library, and Web of Science up to May 2023. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS) and the Methodological Quality and Synthesis of Case Series and Case Reports tool. Data statistics and analysis were performed using Stata 15.1 software (StataSE, USA).</p></sec><sec><title>Results</title><p>Six studies involving 339 patients were included in the analysis. Meta-analysis revealed that Simultaneous Radical Cystectomy and Nephroureterectomy had 2-year and 5-year overall survival rates of 68% (95% CI 60%-76%, I<sup>2</sup> = 12.4%, P &lt; 0.001) and 44% (95% CI 36%-53%, I<sup>2 </sup>= 0, P &lt; 0.001), respectively. The 2-year and 5-year progression-free survival rates were 91% (95% CI 86%-95%, I<sup>2 </sup>= 95%, P &lt; 0.001) and 65% (95% CI 58%-73%, I<sup>2 </sup>= 91.5%, P &lt; 0.001), respectively. The 2-year and 5-year cancer-specific survival rates were 73% (95% CI 66%-81%, I<sup>2 </sup>= 16.7%, P &lt; 0.001) and 57% (95% CI 49%-66%, I<sup>2 </sup>= 0, P &lt; 0.001), respectively. Additionally, the incidence of minor complications was 19% (95% CI 15%-23%, P &lt; 0.01), major complications was 49% (95% CI 34%-63%, P &lt; 0.01), and the intraoperative blood transfusion rate was 53% (95% CI 44%-61%, P &lt; 0.01).</p></sec><sec><title>Conclusions</title><p>Simultaneous radical cystectomy and nephroureterectomy represent feasible approaches for the treatment of Panurothelial carcinoma. Nonetheless, a comprehensive assessment of the surgical risks and benefits is imperative, and larger-scale prospective cohort studies are required to validate therapeutic efficacy. </p></sec><sec><title>Systematic review registration</title><p><uri xlink:href="https://www.crd.york.ac.uk/PROSPERO" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO</uri>, identifier CRD42023426401.</p></sec>