Department of Urology, First Affiliated Hospital of Dalian Medical University , 222 Zhong Shan Road, Dalian, Liaoning 116011 , P.R. China.
Expert Rev Anticancer Ther. 2014 Jun;14(6):667-75. doi: 10.1586/14737140.2014.895670. Epub 2014 Mar 27.
A systematic search was conducted in PubMed, Cochrane Library. 6032 patients were included. There was no significant difference in survival between LND and NLND (non-lymph node dissection) among the patients. However, the patients in the LND group had more advanced tumour stages and grades (p < 0.001). In addition, among the muscle-invasive patients, LND demonstrated remarkable CSS improvement compared with NLND (HR: 2.19; 95% CI: 1.26-3.80; p = 0.005). Moreover, subgroup analyses found that patients with muscle-invasive UTUC had better CSS (HR: 1.22; 95% CI: 1.02-1.45; p < 0.001) than those patients with pN0 compared to pNx (NLND). In terms of RFS, the results showed no difference in the survival rates between pN0 and pNx patients in the subgroup of patients with muscle-invasive UTUC (HR: 1.40; 95% CI: 0.84-2.23; p = 0.19). Our meta-analysis supports that LND may prolong the CSS and RFS of UTUC, especially for patients with muscle-invasive UTUC.
系统检索了 PubMed 和 Cochrane Library，共纳入 6032 例患者。LND 组和 NLND 组（非淋巴结清扫术）患者的生存无显著差异。然而，LND 组患者的肿瘤分期和分级更高（p<0.001）。此外，在肌层浸润性患者中，与 NLND 相比，LND 可显著改善 CSS（HR：2.19；95%CI：1.26-3.80；p=0.005）。此外，亚组分析发现，与 pNx（NLND）相比，肌层浸润性 UTUC 患者的 CSS 更好（HR：1.22；95%CI：1.02-1.45；p<0.001）。在 RFS 方面，结果显示肌层浸润性 UTUC 患者亚组中 pN0 和 pNx 患者的生存率无差异（HR：1.40；95%CI：0.84-2.23；p=0.19）。本 meta 分析支持 LND 可能延长 UTUC 的 CSS 和 RFS，特别是对肌层浸润性 UTUC 患者。
