Oncological impact of cystoscopic findings in non-muscle-invasive bladder cancer
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Oncological impact of cystoscopic findings in non-muscle-invasive bladder cancer. / Yanagisawa, Takafumi; Quhal, Fahad; Kawada, Tatsushi; Mostafaei, Hadi; Sari Motlagh, Reza; Laukhtina, Ekaterina; Rajwa, Pawel; von Deimling, Markus; Bianchi, Alberto; Pallauf, Maximilian; Majdoub, Muhammad; Pradère, Benjamin; Abufaraj, Mohammad; Moschini, Marco; Karakiewicz, Pierre I; Iwatani, Kosuke; Miki, Jun; Kimura, Takahiro; Shariat, Shahrokh F.
in: BJU INT, Jahrgang 131, Nr. 6, 06.2023, S. 643-659.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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T1 - Oncological impact of cystoscopic findings in non-muscle-invasive bladder cancer
AU - Yanagisawa, Takafumi
AU - Quhal, Fahad
AU - Kawada, Tatsushi
AU - Mostafaei, Hadi
AU - Sari Motlagh, Reza
AU - Laukhtina, Ekaterina
AU - Rajwa, Pawel
AU - von Deimling, Markus
AU - Bianchi, Alberto
AU - Pallauf, Maximilian
AU - Majdoub, Muhammad
AU - Pradère, Benjamin
AU - Abufaraj, Mohammad
AU - Moschini, Marco
AU - Karakiewicz, Pierre I
AU - Iwatani, Kosuke
AU - Miki, Jun
AU - Kimura, Takahiro
AU - Shariat, Shahrokh F
PY - 2023/6
Y1 - 2023/6
N2 - ObjectiveTo assess the association between cystoscopic findings and oncological outcomes in patients with non-muscle-invasive bladder cancer (NMIBC) given that the oncological impact of quantity and quality assessment of tumours with cystoscopy has not been well verified.MethodsMultiple databases were queried in May 2022 for studies investigating the association of oncological outcomes, such as recurrence-free (RFS), progression-free (PFS), and cancer-specific survival (CSS), with cystoscopic findings, including multiplicity, size, and gross appearance of tumours in patients with NMIBC.ResultsOverall, 73 studies comprising 28 139 patients were eligible for the meta-analysis. Tumour multiplicity was associated with worse RFS (pooled hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.48–1.74) and PFS (pooled HR 1.44, 95% CI 1.18–1.76) in NMIBC patients (including both Ta and T1). Tumour size (≥3 cm) was associated with worse RFS (pooled HR 1.97, 95% CI 1.69–2.30) and PFS (pooled HR 1.81, 95% CI 1.52–2.15) in NMIBC patients. In patients with T1 bladder cancer (BCa), tumour multiplicity and size (≥3 cm) were also associated with worse RFS, PFS and CSS. By contrast, among patients treated with bacillus Calmette-Guérin (BCG), tumour multiplicity was not associated with worse RFS, and tumour size (≥3 cm) was not associated with worse PFS. Sessile tumours were associated with worse RFS (pooled HR 2.14, 95% CI 1.52–3.01) and PFS (pooled HR 2.17, 95% CI 1.42–3.32) compared to pedunculated tumours. Compared to papillary tumours, solid tumours were associated with worse RFS (pooled HR 1.84, 95% CI 1.25–2.72) and PFS (pooled HR 3.06, 95% CI 2.31–4.07) in NMIBC patients, and CSS in T1 BCa patients (pooled HR 2.32, 95% CI 1.63–3.30).ConclusionsCystoscopic findings, including tumour multiplicity, size, and gross appearance, strongly predict oncological outcomes in NMIBC patients. Cystoscopic visual features can help in the decision-making process regarding the timeliness and extent of tumour resection as well as future management such as intravesical therapy.
AB - ObjectiveTo assess the association between cystoscopic findings and oncological outcomes in patients with non-muscle-invasive bladder cancer (NMIBC) given that the oncological impact of quantity and quality assessment of tumours with cystoscopy has not been well verified.MethodsMultiple databases were queried in May 2022 for studies investigating the association of oncological outcomes, such as recurrence-free (RFS), progression-free (PFS), and cancer-specific survival (CSS), with cystoscopic findings, including multiplicity, size, and gross appearance of tumours in patients with NMIBC.ResultsOverall, 73 studies comprising 28 139 patients were eligible for the meta-analysis. Tumour multiplicity was associated with worse RFS (pooled hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.48–1.74) and PFS (pooled HR 1.44, 95% CI 1.18–1.76) in NMIBC patients (including both Ta and T1). Tumour size (≥3 cm) was associated with worse RFS (pooled HR 1.97, 95% CI 1.69–2.30) and PFS (pooled HR 1.81, 95% CI 1.52–2.15) in NMIBC patients. In patients with T1 bladder cancer (BCa), tumour multiplicity and size (≥3 cm) were also associated with worse RFS, PFS and CSS. By contrast, among patients treated with bacillus Calmette-Guérin (BCG), tumour multiplicity was not associated with worse RFS, and tumour size (≥3 cm) was not associated with worse PFS. Sessile tumours were associated with worse RFS (pooled HR 2.14, 95% CI 1.52–3.01) and PFS (pooled HR 2.17, 95% CI 1.42–3.32) compared to pedunculated tumours. Compared to papillary tumours, solid tumours were associated with worse RFS (pooled HR 1.84, 95% CI 1.25–2.72) and PFS (pooled HR 3.06, 95% CI 2.31–4.07) in NMIBC patients, and CSS in T1 BCa patients (pooled HR 2.32, 95% CI 1.63–3.30).ConclusionsCystoscopic findings, including tumour multiplicity, size, and gross appearance, strongly predict oncological outcomes in NMIBC patients. Cystoscopic visual features can help in the decision-making process regarding the timeliness and extent of tumour resection as well as future management such as intravesical therapy.
U2 - 10.1111/bju.15944
DO - 10.1111/bju.15944
M3 - SCORING: Review article
C2 - 36479820
VL - 131
SP - 643
EP - 659
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 6
ER -