S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) Theses (Master's Degree_의학과)
Presence of lymphovascular invasion in urothelial bladder cancer specimens after transurethral resections correlates with risk of upstaging and survival
방광암에 대한 경요도 절제 검체에서 관찰되는 임파 혈관 침윤의 술 후 종양 병기 상승과 생존과의 관련성 :
- 의과대학 의학과
- Issue Date
- 서울대학교 대학원
- Bladder cancer; urothelial carcinoma; meta-analysis; lymphovascular invasion; prognosis; transurethral resection
- 학위논문 (석사)-- 서울대학교 대학원 : 의학과 비뇨기과학 전공, 2016. 2. 구자현.
- Objectives: This study aimed to elucidate the relationship between lymphovascular invasion (LVI) at transurethral resection of bladder tumor (TURBT) and the risk of pathological upstaging as well as the clinical outcomes.
Materials and Methods: PubMed, SCOPUS, Web of Science and Cochrane Library databases were searched from the respective dates of inception until November 11, 2013.
Results: A total of 16 articles met the eligibility criteria for this systematic review, which included a total of 3,905 patients. LVI was detected in 18.6% in TURBT specimens. The significant association was found between LVI at TURBT and pathological upstaging of bladder cancer (odds ratio 2.21, 95% confidence interval [CI] 1.44-3.39) without heterogeneity (I2 45%, p = 0.14). The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (HR 1.47, 95% CI 1.24-1.74), progression-free survival (HR 2.28, 95% CI 1.45-3.58), and disease-specific survival HR, 1.35
95% CI, 1.01-1.81), but not overall survival (HR, 1.55
95% CI, 0.90-2.67). Tests of inconsistency for disease-specific survival (I2 66%, p = 0.007) and overall survival (I2 72%, p = 0.03) could not exclude a significant heterogeneity. The results of Beggs and Eggers test showed that there was evidence of publication bias on pathological upstaging and progression-free survival.
Conclusions: The data obtained in this meta-analysis indicate that the presence of LVI at TURBT portends the increased risk of pathological upstaging and may provide additional prognostic information. However, a large, well-designed, prospective study is needed to investigate potential treatment options for bladder cancer with LVI.