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同时经尿道切除膀胱癌和前列腺的临床疗效评估:系统评价和荟萃分析。

Assessment of the clinical efficacy of simultaneous transurethral resection of both bladder cancer and the prostate: a systematic review and meta-analysis.

机构信息

Department of Urology, Maoming People's Hospital, Maoming, China.

Department of Dermatology, Maoming People's Hospital, Maoming, China.

出版信息

Aging Male. 2020 Dec;23(5):1182-1193. doi: 10.1080/13685538.2020.1718637. Epub 2020 Feb 5.

DOI:10.1080/13685538.2020.1718637
PMID:32020826
Abstract

OBJECTIVE

In this study, we aimed to examine the clinical efficacy of simultaneous transurethral resection of bladder cancer and the prostate (TURBT + TURP) in non-muscle invasive bladder cancer (NMIBC) and benign prostatic hyperplasia (BPH) patients.

METHOD

We conducted systematic research in PubMed, EMBASE, and Cochrane Library databases to identify retrospective studies and prospective randomized controlled trials (RCTs) comparing patient outcomes between TURBT + TURP and TURBT-only patients. The meta-analysis was conducted using Review Manager 5.3.

RESULTS

We identified eight relevant studies involving a total of 1032 patients. We found that patients that underwent TURBT + TURP exhibited significantly lower recurrence rates [odds ratio (OR), 0.70; 95% confidence interval (CI), 0.53-0.93;  = .01] and increased maximal urinary flow rate (Qmax) (WMD, 5.92; 95% CI, 4.67-7.16;  < .001) compared with patients that underwent TURBT-only. However, rates of recurrence at the prostatic urethra/bladder neck and bladder tumor progression, as well as the time to recurrence did not differ significantly between these two groups.

CONCLUSIONS

Simultaneous TURBT + TURP can be safely performed in patients with NMIBC and BPH and improves patient quality of life, without any risk of increasing tumor recurrence or metastasis rates. Comprehensive RCTs are needed to confirm the results of this study.

摘要

目的

本研究旨在探讨非肌层浸润性膀胱癌(NMIBC)合并良性前列腺增生(BPH)患者同期行经尿道膀胱肿瘤电切术(TURBT)联合经尿道前列腺电切术(TURP)的临床疗效。

方法

我们在 PubMed、EMBASE 和 Cochrane Library 数据库中进行系统检索,以确定比较 TURBT+TURP 与 TURBT 单一治疗患者结局的回顾性研究和前瞻性随机对照试验(RCT)。使用 Review Manager 5.3 进行荟萃分析。

结果

我们共纳入 8 项相关研究,共计 1032 例患者。结果显示,与 TURBT 单一治疗相比,TURBT+TURP 组患者的复发率显著降低[比值比(OR),0.70;95%置信区间(CI),0.53-0.93; = .01],最大尿流率(Qmax)增加(加权均数差(WMD),5.92;95%CI,4.67-7.16; < .001)。然而,两组患者在前列腺尿道/膀胱颈部复发率、膀胱肿瘤进展率以及复发时间方面差异无统计学意义。

结论

对于 NMIBC 和 BPH 患者,同期行 TURBT+TURP 是安全可行的,可提高患者的生活质量,且不会增加肿瘤复发或转移的风险。需要进行全面的 RCT 来验证本研究的结果。

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