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Differential Effect of Sex on Outcomes after Radical Surgery for Upper Tract and Bladder Urothelial Carcinoma: A Systematic Review and Meta-Analysis.

性别对上尿路和膀胱尿路上皮癌根治术后结局的差异影响: 系统综述和荟萃分析。

  • 影响因子:1.46
  • DOI:10.1097/JU.0000000000000788
  • 作者列表:"Mori K","Mostafaei H","Enikeev DV","Lysenko I","Quhal F","Kimura S","Karakiewicz PI","Egawa S","Shariat SF
  • 发表时间:2020-07-01
Abstract

PURPOSE:We assessed the prognostic value of sex differences in upper tract urothelial carcinoma and urothelial carcinoma of the bladder treated with radical surgery. MATERIALS AND METHODS:The PubMed®, Web of Science®, Cochrane Library and Scopus® databases were searched in July 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were deemed eligible if they compared overall, cancer specific, and recurrence-free survival in patients with upper tract urothelial carcinoma and urothelial carcinoma of the bladder. Formal meta-analyses were performed for these outcomes according to sex differences. RESULTS:Overall 66 studies with 100,389 patients with urothelial carcinoma of the bladder and 40 studies with 39,759 patients with upper tract urothelial carcinoma were eligible for review and meta-analysis. Female patients with urothelial carcinoma of the bladder were associated with worse cancer specific survival (pooled HR 1.20, 95% CI 1.10-1.31), overall survival (pooled HR 1.03, 95% CI 1.01-1.05) and recurrence-free survival (pooled HR 1.13, 95% CI 1.02-1.25). In contrast, those with upper tract urothelial carcinoma were not associated with cancer specific survival (pooled HR 0.94, 95% CI 0.89-1.00), overall survival (pooled HR 0.98, 95% CI 0.95-1.01) and recurrence-free survival (pooled HR 0.90, 95% CI 0.78-1.03). CONCLUSIONS:Sex is associated with cancer specific mortality, overall mortality and disease recurrence in urothelial carcinoma of the bladder but not in upper tract urothelial carcinoma. Given the genetic and social differences between the sexes, sex differences may represent a key factor in the clinical decision making process.

摘要

目的: 我们评估根治性手术治疗上尿路尿路上皮癌和膀胱尿路上皮癌的性别差异的预后价值。 材料和方法: PubMed®,Web of Science®、Cochrane图书馆和Scopus®根据系统评价和荟萃分析声明的首选报告项目,在2019年7月检索数据库。如果比较上尿路尿路上皮癌和膀胱尿路上皮癌患者的总体、癌症特异性和无复发生存期,则认为研究是合格的。根据性别差异对这些结果进行了正式的荟萃分析。 结果: 共有66项研究,包括100,389例膀胱尿路上皮癌患者和40项研究,包括39,759例上尿路尿路上皮癌患者,符合回顾和荟萃分析的标准。患有膀胱尿路上皮癌的女性患者与较差的癌症特异性生存期 (合并HR 1.20,95% CI 1.10-1.31),总生存期 (合并HR 1.03,95% CI 1.01-1.05) 和无复发生存期 (合并HR 1.13,95% CI 1.02-1.25) 相关。相比之下,上尿路尿路上皮癌患者与癌症特异性生存期 (合并HR 0.94,95% CI 0.89-1.00),总生存期 (合并HR 0.98,95% CI 0.95-1.01) 和无复发生存期 (合并HR 0.90,95% CI 0.78-1.03) 无关。 结论: 性别与膀胱尿路上皮癌的癌症特异性死亡率、总死亡率和疾病复发相关,而与上尿路尿路上皮癌无关。鉴于性别之间的遗传和社会差异,性别差异可能是临床决策过程中的一个关键因素。

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影响因子:2.56
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来源期刊:The Journal of urology
DOI:10.1097/JU.0000000000000313
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泌尿外科手术方向

泌尿系统出现一些病变,需要通过手术来治疗,这些手术就称为泌尿外科手术。

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