Comparison of clinicopathologic and oncological outcomes between Trans-Urethral En Bloc (TUEB) Resection and Conventional Trans-Urethral Resection of Bladder Tumor (cTURBT): a systematic review, meta-analysis and network meta-analysis with focus on Different energy sources

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F22%3A10433035" target="_blank" >RIV/00064203:_____/22:10433035 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11130/22:10433035

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=~B5qtU90m4" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=~B5qtU90m4</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1089/end.2021.0688" target="_blank" >10.1089/end.2021.0688</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Comparison of clinicopathologic and oncological outcomes between Trans-Urethral En Bloc (TUEB) Resection and Conventional Trans-Urethral Resection of Bladder Tumor (cTURBT): a systematic review, meta-analysis and network meta-analysis with focus on Different energy sources

Popis výsledku v původním jazyce

INTRODUCTION: It has been hypothesized that transurethral en bloc resection of bladder tumor (TUEB) offers benefits over conventional transurethral resection of bladder tumor (cTURBT). This study aimed to compare disease outcomes of TUEB and cTURBT with focus on the different energy sources. METHOD: A systematic search was performed using PubMed and Web of Science databases in June 2021. Studies that compared the pathological (detrusor muscle presence), oncological (recurrence rates) efficacy, and safety (serious adverse events ([SAEs]) of TUEB and cTURBT were included. Random- and fixed-effects meta-analytic models and Bayesian approach in the network meta-analysis was used. RESULTS: Seven randomized clinical trials (RCT) and seven non-RCTs (NRCT), with a total of 2,092 patients. The pooled 3- and 12-month recurrence risk ratio (RR) of five and four NRCTs were 0.46 (95% CI; 0.29- 0.73) and 0.56 (95% CI; 0.33- 0.96), respectively. The pooled 3- and 12-month recurrence risk RRs of four and seven RCTs were 0.57 (95% CI; 0.25- 1.27) and 0.89 (95% CI; 0.69- 1.15), respectively. The pooled RR for SAEs such as prolonged hematuria and bladder perforation of seven RCTs was 0.16 (95% CI; 0.06- 0.41) in benefit of TUEB. Seven RCTs (n= 1077) met our eligibility criteria for network meta-analysis. There was no difference in 12-month recurrence rates between hybridknife, laser, and bipolar TUEB compared to cTURBT. Contrary, laser TUEB was significantly associated with lower SAEs compared to cTURBT. SUCRA ranking analyses showed with high certainty that laser TUEB was the best treatment option to access all endpoints. CONCLUSION: While NRCTs suggested a recurrence-free benefit to TUEB compared to cTURBT, RCTs failed to confirm this. Conversely, SAEs were consistently and clinically significantly better for TUEB. Network meta-analyses suggested laser TUEB has the best performance compared to other energy sources. These early findings need to be confirmed and expanded upon.

Název v anglickém jazyce

Comparison of clinicopathologic and oncological outcomes between Trans-Urethral En Bloc (TUEB) Resection and Conventional Trans-Urethral Resection of Bladder Tumor (cTURBT): a systematic review, meta-analysis and network meta-analysis with focus on Different energy sources

Popis výsledku anglicky

INTRODUCTION: It has been hypothesized that transurethral en bloc resection of bladder tumor (TUEB) offers benefits over conventional transurethral resection of bladder tumor (cTURBT). This study aimed to compare disease outcomes of TUEB and cTURBT with focus on the different energy sources. METHOD: A systematic search was performed using PubMed and Web of Science databases in June 2021. Studies that compared the pathological (detrusor muscle presence), oncological (recurrence rates) efficacy, and safety (serious adverse events ([SAEs]) of TUEB and cTURBT were included. Random- and fixed-effects meta-analytic models and Bayesian approach in the network meta-analysis was used. RESULTS: Seven randomized clinical trials (RCT) and seven non-RCTs (NRCT), with a total of 2,092 patients. The pooled 3- and 12-month recurrence risk ratio (RR) of five and four NRCTs were 0.46 (95% CI; 0.29- 0.73) and 0.56 (95% CI; 0.33- 0.96), respectively. The pooled 3- and 12-month recurrence risk RRs of four and seven RCTs were 0.57 (95% CI; 0.25- 1.27) and 0.89 (95% CI; 0.69- 1.15), respectively. The pooled RR for SAEs such as prolonged hematuria and bladder perforation of seven RCTs was 0.16 (95% CI; 0.06- 0.41) in benefit of TUEB. Seven RCTs (n= 1077) met our eligibility criteria for network meta-analysis. There was no difference in 12-month recurrence rates between hybridknife, laser, and bipolar TUEB compared to cTURBT. Contrary, laser TUEB was significantly associated with lower SAEs compared to cTURBT. SUCRA ranking analyses showed with high certainty that laser TUEB was the best treatment option to access all endpoints. CONCLUSION: While NRCTs suggested a recurrence-free benefit to TUEB compared to cTURBT, RCTs failed to confirm this. Conversely, SAEs were consistently and clinically significantly better for TUEB. Network meta-analyses suggested laser TUEB has the best performance compared to other energy sources. These early findings need to be confirmed and expanded upon.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Endourology

ISSN

0892-7790

e-ISSN

1557-900X

Svazek periodika

36

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

13

Strana od-do

535-547

Kód UT WoS článku

000719861400001

EID výsledku v databázi Scopus

2-s2.0-85125851992