Department of Urology, Medical University of Vienna, Vienna, Austria.
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
BJU Int. 2021 Feb;127(2):143-152. doi: 10.1111/bju.15146. Epub 2020 Aug 12.
To evaluate recurrence and progression risk after simultaneous endoscopic surgery of bladder cancer and benign prostatic hyperplasia (BPH), as simultaneous surgery is not an unusual scenario and theoretically simultaneous transurethral resection of bladder tumour (TURBT) and transurethral resection of the prostate (TURP) can lead to an increased risk of recurrence in the bladder neck and prostatic urethra (BN/PU).
We conducted a systematic review and meta-analysis to assess the risk of recurrence (i.e. whole bladder and/or BN/PU) and tumour progression as outcomes after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone. We queried PubMed and Web of Science database on 1 January 2020. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to the I statistic, respectively.
Nine retrospective and three clinical trial studies were selected after considering inclusion and exclusion criteria. We conducted the meta-analysis on retrospective and randomised controlled trials (RCTs) separately. Eight retrospective and three RCT studies were included to assess the BN/PU recurrence risk and the summarised risk ratio (RR) was 1.02 (95% confidence interval [CI] 0.74-1.41) and 0.93 (95% CI 0.47-1.84), respectively. Five retrospective and two RCT studies were included to assess the progression risk and the summarised RR was 0.91 (95% CI 0.56-1.48) and 1.16 (95% CI 0.30-4.51), respectively. Eight retrospective and three RCT studies were included to assess the whole bladder recurrence risk and the summarised RR was 0.87 (95% CI 0.78-0.97) and 0.89 (95% CI 0.65-1.21), respectively.
We did not observe any increased risk of total bladder recurrence, BN/PU recurrence, or progression after a simultaneous endoscopic surgery of bladder tumour and BPH, as compared to TURBT alone.
评估膀胱癌和良性前列腺增生（BPH）同期内镜手术后的复发和进展风险，因为同期手术并非罕见情况，理论上同期经尿道膀胱肿瘤切除术（TURBT）和经尿道前列腺切除术（TURP）可能会增加膀胱颈部和前列腺尿道（BN/PU）的复发风险。
我们进行了系统评价和荟萃分析，以评估膀胱癌和 BPH 同期内镜手术后的复发（即全膀胱和/或 BN/PU）和肿瘤进展作为结局的风险，与单独 TURBT 相比。我们于 2020 年 1 月 1 日查询了 PubMed 和 Web of Science 数据库。根据 I 统计量，我们分别使用随机效应和/或固定效应荟萃分析模型来评估存在或不存在异质性的情况。
在考虑纳入和排除标准后，共选择了 9 项回顾性研究和 3 项临床试验研究。我们分别对回顾性和随机对照试验（RCT）进行了荟萃分析。纳入了 8 项回顾性研究和 3 项 RCT 研究来评估 BN/PU 复发风险，汇总的风险比（RR）分别为 1.02（95%置信区间 [CI] 0.74-1.41）和 0.93（95% CI 0.47-1.84）。纳入了 5 项回顾性研究和 2 项 RCT 研究来评估进展风险，汇总的 RR 分别为 0.91（95% CI 0.56-1.48）和 1.16（95% CI 0.30-4.51）。纳入了 8 项回顾性研究和 3 项 RCT 研究来评估全膀胱复发风险，汇总的 RR 分别为 0.87（95% CI 0.78-0.97）和 0.89（95% CI 0.65-1.21）。
与单独 TURBT 相比，膀胱癌和 BPH 同期内镜手术后，全膀胱复发、BN/PU 复发或进展的风险并未增加。
