Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis
Objective To 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. Methods Multiple databases...
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| Veröffentlicht in: | BJU international 2023-06, Vol.131 (6), p.643-659 |
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| creator | Yanagisawa, Takafumi Quhal, Fahad Kawada, Tatsushi Mostafaei, Hadi Motlagh, Reza Sari Laukhtina, Ekaterina Rajwa, Pawel Deimling, Markus Bianchi, Alberto Pallauf, Maximilian Majdoub, Muhammad Pradere, Benjamin Abufaraj, Mohammad Moschini, Marco Karakiewicz, Pierre I. Iwatani, Kosuke Miki, Jun Kimura, Takahiro Shariat, Shahrokh F. |
| description | Objective
To 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.
Methods
Multiple 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.
Results
Overall, 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).
Conclusions
Cystoscopic 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. |
| doi_str_mv | 10.1111/bju.15944 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2753301448</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2817292864</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3884-17e591ecf56ca8a6886794f39bc65499254a483ede900fbb997cda855776fd213</originalsourceid><addsrcrecordid>eNp1kMtKAzEUQIMotlYX_oAE3OiibTKTZBJ3WnxS6MaCuyGTyZSUTFInnUp3foLf6JcYbetC8G5yCYfD5QBwitEAxxkW83aAqSBkD3QxYaRPMHrZ3-1IsA44CmGOUPxg9BB0UkYywRPUBbOJU976mVHSQlMvpFpCX0G1DksflF8YBSvjSuNmARoHnXef7x91G5TVcTFuJYNZaVhYWZa6gUo6pZsrKGGtlzIS0km7DiYcg4NK2qBPtm8PTO9un0cP_fHk_nF0Pe6rlHPSx5mmAmtVUaYkl4xzlglSpaJQjBIhEkok4akutUCoKgohMlVKTmmWsapMcNoDFxvvovGvrQ7LvDZBaWul074NeZLRNI0doqQHzv-gc9828d5IcZwlIuGMROpyQ6nGh9DoKl80ppbNOsco_66fx_r5T_3Inm2NbVHr8pfc5Y7AcAO8GavX_5vym6fpRvkF8m-Rlg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2817292864</pqid></control><display><type>article</type><title>Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Yanagisawa, Takafumi ; Quhal, Fahad ; Kawada, Tatsushi ; Mostafaei, Hadi ; Motlagh, Reza Sari ; Laukhtina, Ekaterina ; Rajwa, Pawel ; Deimling, Markus ; Bianchi, Alberto ; Pallauf, Maximilian ; Majdoub, Muhammad ; Pradere, Benjamin ; Abufaraj, Mohammad ; Moschini, Marco ; Karakiewicz, Pierre I. ; Iwatani, Kosuke ; Miki, Jun ; Kimura, Takahiro ; Shariat, Shahrokh F.</creator><creatorcontrib>Yanagisawa, Takafumi ; Quhal, Fahad ; Kawada, Tatsushi ; Mostafaei, Hadi ; Motlagh, Reza Sari ; Laukhtina, Ekaterina ; Rajwa, Pawel ; Deimling, Markus ; Bianchi, Alberto ; Pallauf, Maximilian ; Majdoub, Muhammad ; Pradere, Benjamin ; Abufaraj, Mohammad ; Moschini, Marco ; Karakiewicz, Pierre I. ; Iwatani, Kosuke ; Miki, Jun ; Kimura, Takahiro ; Shariat, Shahrokh F.</creatorcontrib><description>Objective
To 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.
Methods
Multiple 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.
Results
Overall, 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).
Conclusions
Cystoscopic 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.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/bju.15944</identifier><identifier>PMID: 36479820</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Administration, Intravesical ; BCG Vaccine - therapeutic use ; Bladder cancer ; BladderCancer ; blcsm ; Cancer ; Cystoscopy ; Decision making ; gross appearance ; Humans ; Invasiveness ; Meta-analysis ; multiplicity ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Non-Muscle Invasive Bladder Neoplasms ; non‐muscle‐invasive bladder cancer ; progression ; Proportional Hazards Models ; Quality control ; recurrence ; Retrospective Studies ; size ; Solid tumors ; Tumors ; Urinary Bladder Neoplasms - pathology ; uroonc</subject><ispartof>BJU international, 2023-06, Vol.131 (6), p.643-659</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd on behalf of BJU International.</rights><rights>2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-17e591ecf56ca8a6886794f39bc65499254a483ede900fbb997cda855776fd213</citedby><cites>FETCH-LOGICAL-c3884-17e591ecf56ca8a6886794f39bc65499254a483ede900fbb997cda855776fd213</cites><orcidid>0000-0002-8163-6953 ; 0000-0002-5673-1553 ; 0000-0002-6627-6179 ; 0000-0002-3819-9911 ; 0000-0002-7768-8558 ; 0000-0002-4638-8640 ; 0000-0002-7410-0712 ; 0000-0002-9954-3413 ; 0000-0002-3084-2458 ; 0000-0003-4073-6584 ; 0000-0002-8496-4506 ; 0000-0002-8369-9712 ; 0000-0002-8953-0272 ; 0000-0001-5596-1771 ; 0000-0002-6603-6319</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbju.15944$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbju.15944$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36479820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yanagisawa, Takafumi</creatorcontrib><creatorcontrib>Quhal, Fahad</creatorcontrib><creatorcontrib>Kawada, Tatsushi</creatorcontrib><creatorcontrib>Mostafaei, Hadi</creatorcontrib><creatorcontrib>Motlagh, Reza Sari</creatorcontrib><creatorcontrib>Laukhtina, Ekaterina</creatorcontrib><creatorcontrib>Rajwa, Pawel</creatorcontrib><creatorcontrib>Deimling, Markus</creatorcontrib><creatorcontrib>Bianchi, Alberto</creatorcontrib><creatorcontrib>Pallauf, Maximilian</creatorcontrib><creatorcontrib>Majdoub, Muhammad</creatorcontrib><creatorcontrib>Pradere, Benjamin</creatorcontrib><creatorcontrib>Abufaraj, Mohammad</creatorcontrib><creatorcontrib>Moschini, Marco</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><creatorcontrib>Iwatani, Kosuke</creatorcontrib><creatorcontrib>Miki, Jun</creatorcontrib><creatorcontrib>Kimura, Takahiro</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><title>Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Objective
To 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.
Methods
Multiple 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.
Results
Overall, 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).
Conclusions
Cystoscopic 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.</description><subject>Administration, Intravesical</subject><subject>BCG Vaccine - therapeutic use</subject><subject>Bladder cancer</subject><subject>BladderCancer</subject><subject>blcsm</subject><subject>Cancer</subject><subject>Cystoscopy</subject><subject>Decision making</subject><subject>gross appearance</subject><subject>Humans</subject><subject>Invasiveness</subject><subject>Meta-analysis</subject><subject>multiplicity</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Non-Muscle Invasive Bladder Neoplasms</subject><subject>non‐muscle‐invasive bladder cancer</subject><subject>progression</subject><subject>Proportional Hazards Models</subject><subject>Quality control</subject><subject>recurrence</subject><subject>Retrospective Studies</subject><subject>size</subject><subject>Solid tumors</subject><subject>Tumors</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>uroonc</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kMtKAzEUQIMotlYX_oAE3OiibTKTZBJ3WnxS6MaCuyGTyZSUTFInnUp3foLf6JcYbetC8G5yCYfD5QBwitEAxxkW83aAqSBkD3QxYaRPMHrZ3-1IsA44CmGOUPxg9BB0UkYywRPUBbOJU976mVHSQlMvpFpCX0G1DksflF8YBSvjSuNmARoHnXef7x91G5TVcTFuJYNZaVhYWZa6gUo6pZsrKGGtlzIS0km7DiYcg4NK2qBPtm8PTO9un0cP_fHk_nF0Pe6rlHPSx5mmAmtVUaYkl4xzlglSpaJQjBIhEkok4akutUCoKgohMlVKTmmWsapMcNoDFxvvovGvrQ7LvDZBaWul074NeZLRNI0doqQHzv-gc9828d5IcZwlIuGMROpyQ6nGh9DoKl80ppbNOsco_66fx_r5T_3Inm2NbVHr8pfc5Y7AcAO8GavX_5vym6fpRvkF8m-Rlg</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Yanagisawa, Takafumi</creator><creator>Quhal, Fahad</creator><creator>Kawada, Tatsushi</creator><creator>Mostafaei, Hadi</creator><creator>Motlagh, Reza Sari</creator><creator>Laukhtina, Ekaterina</creator><creator>Rajwa, Pawel</creator><creator>Deimling, Markus</creator><creator>Bianchi, Alberto</creator><creator>Pallauf, Maximilian</creator><creator>Majdoub, Muhammad</creator><creator>Pradere, Benjamin</creator><creator>Abufaraj, Mohammad</creator><creator>Moschini, Marco</creator><creator>Karakiewicz, Pierre I.</creator><creator>Iwatani, Kosuke</creator><creator>Miki, Jun</creator><creator>Kimura, Takahiro</creator><creator>Shariat, Shahrokh F.</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8163-6953</orcidid><orcidid>https://orcid.org/0000-0002-5673-1553</orcidid><orcidid>https://orcid.org/0000-0002-6627-6179</orcidid><orcidid>https://orcid.org/0000-0002-3819-9911</orcidid><orcidid>https://orcid.org/0000-0002-7768-8558</orcidid><orcidid>https://orcid.org/0000-0002-4638-8640</orcidid><orcidid>https://orcid.org/0000-0002-7410-0712</orcidid><orcidid>https://orcid.org/0000-0002-9954-3413</orcidid><orcidid>https://orcid.org/0000-0002-3084-2458</orcidid><orcidid>https://orcid.org/0000-0003-4073-6584</orcidid><orcidid>https://orcid.org/0000-0002-8496-4506</orcidid><orcidid>https://orcid.org/0000-0002-8369-9712</orcidid><orcidid>https://orcid.org/0000-0002-8953-0272</orcidid><orcidid>https://orcid.org/0000-0001-5596-1771</orcidid><orcidid>https://orcid.org/0000-0002-6603-6319</orcidid></search><sort><creationdate>202306</creationdate><title>Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis</title><author>Yanagisawa, Takafumi ; Quhal, Fahad ; Kawada, Tatsushi ; Mostafaei, Hadi ; Motlagh, Reza Sari ; Laukhtina, Ekaterina ; Rajwa, Pawel ; Deimling, Markus ; Bianchi, Alberto ; Pallauf, Maximilian ; Majdoub, Muhammad ; Pradere, Benjamin ; Abufaraj, Mohammad ; Moschini, Marco ; Karakiewicz, Pierre I. ; Iwatani, Kosuke ; Miki, Jun ; Kimura, Takahiro ; Shariat, Shahrokh F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-17e591ecf56ca8a6886794f39bc65499254a483ede900fbb997cda855776fd213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Administration, Intravesical</topic><topic>BCG Vaccine - therapeutic use</topic><topic>Bladder cancer</topic><topic>BladderCancer</topic><topic>blcsm</topic><topic>Cancer</topic><topic>Cystoscopy</topic><topic>Decision making</topic><topic>gross appearance</topic><topic>Humans</topic><topic>Invasiveness</topic><topic>Meta-analysis</topic><topic>multiplicity</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Non-Muscle Invasive Bladder Neoplasms</topic><topic>non‐muscle‐invasive bladder cancer</topic><topic>progression</topic><topic>Proportional Hazards Models</topic><topic>Quality control</topic><topic>recurrence</topic><topic>Retrospective Studies</topic><topic>size</topic><topic>Solid tumors</topic><topic>Tumors</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>uroonc</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yanagisawa, Takafumi</creatorcontrib><creatorcontrib>Quhal, Fahad</creatorcontrib><creatorcontrib>Kawada, Tatsushi</creatorcontrib><creatorcontrib>Mostafaei, Hadi</creatorcontrib><creatorcontrib>Motlagh, Reza Sari</creatorcontrib><creatorcontrib>Laukhtina, Ekaterina</creatorcontrib><creatorcontrib>Rajwa, Pawel</creatorcontrib><creatorcontrib>Deimling, Markus</creatorcontrib><creatorcontrib>Bianchi, Alberto</creatorcontrib><creatorcontrib>Pallauf, Maximilian</creatorcontrib><creatorcontrib>Majdoub, Muhammad</creatorcontrib><creatorcontrib>Pradere, Benjamin</creatorcontrib><creatorcontrib>Abufaraj, Mohammad</creatorcontrib><creatorcontrib>Moschini, Marco</creatorcontrib><creatorcontrib>Karakiewicz, Pierre I.</creatorcontrib><creatorcontrib>Iwatani, Kosuke</creatorcontrib><creatorcontrib>Miki, Jun</creatorcontrib><creatorcontrib>Kimura, Takahiro</creatorcontrib><creatorcontrib>Shariat, Shahrokh F.</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yanagisawa, Takafumi</au><au>Quhal, Fahad</au><au>Kawada, Tatsushi</au><au>Mostafaei, Hadi</au><au>Motlagh, Reza Sari</au><au>Laukhtina, Ekaterina</au><au>Rajwa, Pawel</au><au>Deimling, Markus</au><au>Bianchi, Alberto</au><au>Pallauf, Maximilian</au><au>Majdoub, Muhammad</au><au>Pradere, Benjamin</au><au>Abufaraj, Mohammad</au><au>Moschini, Marco</au><au>Karakiewicz, Pierre I.</au><au>Iwatani, Kosuke</au><au>Miki, Jun</au><au>Kimura, Takahiro</au><au>Shariat, Shahrokh F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2023-06</date><risdate>2023</risdate><volume>131</volume><issue>6</issue><spage>643</spage><epage>659</epage><pages>643-659</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objective
To 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.
Methods
Multiple 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.
Results
Overall, 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).
Conclusions
Cystoscopic 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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36479820</pmid><doi>10.1111/bju.15944</doi><tpages>659</tpages><orcidid>https://orcid.org/0000-0002-8163-6953</orcidid><orcidid>https://orcid.org/0000-0002-5673-1553</orcidid><orcidid>https://orcid.org/0000-0002-6627-6179</orcidid><orcidid>https://orcid.org/0000-0002-3819-9911</orcidid><orcidid>https://orcid.org/0000-0002-7768-8558</orcidid><orcidid>https://orcid.org/0000-0002-4638-8640</orcidid><orcidid>https://orcid.org/0000-0002-7410-0712</orcidid><orcidid>https://orcid.org/0000-0002-9954-3413</orcidid><orcidid>https://orcid.org/0000-0002-3084-2458</orcidid><orcidid>https://orcid.org/0000-0003-4073-6584</orcidid><orcidid>https://orcid.org/0000-0002-8496-4506</orcidid><orcidid>https://orcid.org/0000-0002-8369-9712</orcidid><orcidid>https://orcid.org/0000-0002-8953-0272</orcidid><orcidid>https://orcid.org/0000-0001-5596-1771</orcidid><orcidid>https://orcid.org/0000-0002-6603-6319</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_proquest_miscellaneous_2753301448 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Administration, Intravesical BCG Vaccine - therapeutic use Bladder cancer BladderCancer blcsm Cancer Cystoscopy Decision making gross appearance Humans Invasiveness Meta-analysis multiplicity Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Non-Muscle Invasive Bladder Neoplasms non‐muscle‐invasive bladder cancer progression Proportional Hazards Models Quality control recurrence Retrospective Studies size Solid tumors Tumors Urinary Bladder Neoplasms - pathology uroonc |
| title | Oncological impact of cystoscopic findings in non‐muscle‐invasive bladder cancer: a meta‐analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-05T08%3A59%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Oncological%20impact%20of%20cystoscopic%20findings%20in%20non%E2%80%90muscle%E2%80%90invasive%20bladder%20cancer:%20a%20meta%E2%80%90analysis&rft.jtitle=BJU%20international&rft.au=Yanagisawa,%20Takafumi&rft.date=2023-06&rft.volume=131&rft.issue=6&rft.spage=643&rft.epage=659&rft.pages=643-659&rft.issn=1464-4096&rft.eissn=1464-410X&rft_id=info:doi/10.1111/bju.15944&rft_dat=%3Cproquest_cross%3E2817292864%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2817292864&rft_id=info:pmid/36479820&rfr_iscdi=true |