دورية أكاديمية

Extended vs non-extended pelvic lymph node dissection and their influence on recurrence-free survival in patients undergoing radical cystectomy for bladder cancer: a systematic review and meta-analysis of comparative studies.

التفاصيل البيبلوغرافية
العنوان: Extended vs non-extended pelvic lymph node dissection and their influence on recurrence-free survival in patients undergoing radical cystectomy for bladder cancer: a systematic review and meta-analysis of comparative studies.
المؤلفون: Bi, Liangkuan, Huang, Hai, Fan, Xinxiang, Li, Kaiwen, Xu, Kewei, Jiang, Chun, Liu, Hao, Dong, Wen, Zhang, Simin, Yang, Xiangyun, Lin, Tianxin, Huang, Jian
المصدر: BJU International; May2014, Vol. 113 Issue 5b, pE39-E48, 10p
مصطلحات موضوعية: LYMPH nodes, BLADDER cancer, CYSTECTOMY, META-analysis, CLINICAL trials
مستخلص: Objective To compare extended pelvic lymph node dissection ( ePLND) with non-extended pelvic lymph node dissection (non- ePLND) and assess their influence on recurrence-free survival ( RFS) in patients undergoing radical cystectomy for bladder cancer., Methods Through a comprehensive search of the PubMed, Embase and Cochrane Library databases in September 2012, we performed a systematic review and cumulative meta-analysis of all comparative studies assessing the extent of pelvic lymph node dissection ( PLND) and its influence on RFS., Results Six studies with a total of 2824 patients were identified., Overall analysis showed a significantly better RFS rate in patients who had undergone ePLND than in those who had undergone non- ePLND (hazard ratio [ HR]: 0.65; P < 0.001)., A subgroup analysis found that, compared with non- ePLND, ePLND was associated with a better RFS rate for both patients with negative lymph nodes ( HR: 0.68; P = 0.007) and those with positive lymph nodes ( HR: 0.58; P < 0.001). When stratified by pathological T stage, ePLND provided additional RFS benefits for patients with pT3-4 disease ( HR: 0.61; P < 0.001), but not for patients with ≤ pT2 disease ( HR: 0.95; P = 0.81)., Conclusions The results of this meta-analysis indicate that ePLND provides a RFS benefit compared with non- ePLND. On subgroup analysis, ePLND provides better RFS not only for patients who had positive lymph nodes and pT3-4 disease, but also for patients with negative lymph nodes., Two randomized controlled trials on ePLND vs non- ePLND are awaited which should provide more clinically meaningful results. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:14644096
DOI:10.1111/bju.12371