Department of Urology, Pengzhou People's Hospital, Chengdu, Sichuan, China.
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Medicine (Baltimore). 2022 Aug 26;101(34):e30291. doi: 10.1097/MD.0000000000030291.
To understand the long-term oncologic outcomes of open radical cystectomy (ORC) versus laparoscopic radical cystectomy (LRC) versus robot-assisted radical cystectomy (RARC) for bladder cancer (BCa). Therefore, we performed the conventional meta-analysis and network meta-analysis to evaluate the long-term oncologic outcomes of ORC, LRC, and RARC for BCa.
A systematic search of PubMed, Embase, Cochrane Library, Medline, and Web of science was performed up until July 1, 2021. Long-term oncologic outcomes include the 5-year overall survival (OS) rate, the 5-year recurrence-free survival (RFS) rate, and the 5-year cancer specific-survival (CSS) rate. The Bayesian network analysis has been registered in PROSPERO (CRD42020208396).
We found that 10 articles (including 3228 patients) were included in our Bayesian network analysis. No significant differences were found between ORC, LRC, and RARC in long-term oncologic outcomes in either direct meta-analysis or network meta-analysis. Therefore, the clinical effects of 5-year OS, RFS, and CSS of RARC, LRC, and ORC are similar. But LRC may be ranked first in 5-year OS, RFS, and CSS compared to other surgical approaches by probabilistic analysis ranking via Bayesian network analysis.
We found that there were no statistical differences in the 3 surgical approaches of RAPC, LPC, and OPC for Bca in long-term oncologic outcomes by direct meta-analysis. However, Subtle differences between these surgical approaches can be concluded that LRC may be a better surgical approach than RARC or ORC in long-term oncologic outcomes by probabilistic analysis ranking via Bayesian network analysis. Moreover, we need a large sample size and more high-quality studies to improve and verify further.
为了了解膀胱癌患者行开放性根治性膀胱切除术（ORC）、腹腔镜根治性膀胱切除术（LRC）和机器人辅助根治性膀胱切除术（RARC）的长期肿瘤学结果，我们进行了常规的荟萃分析和网络荟萃分析，以评估 ORC、LRC 和 RARC 治疗膀胱癌的长期肿瘤学结果。
系统检索了 PubMed、Embase、Cochrane 图书馆、Medline 和 Web of Science，检索时间截至 2021 年 7 月 1 日。长期肿瘤学结果包括 5 年总生存率（OS）、5 年无复发生存率（RFS）和 5 年癌症特异性生存率（CSS）。贝叶斯网络分析已在 PROSPERO（CRD42020208396）中注册。
我们发现，贝叶斯网络分析纳入了 10 项研究（包括 3228 例患者）。直接荟萃分析或网络荟萃分析均未发现 ORC、LRC 和 RARC 在长期肿瘤学结果方面存在显著差异。因此，RARC、LRC 和 ORC 的 5 年 OS、RFS 和 CSS 的临床效果相似。但通过贝叶斯网络分析的概率分析排名，LRC 在 5 年 OS、RFS 和 CSS 方面可能优于其他手术方法。
我们发现，在直接荟萃分析中，RAPC、LPC 和 OPC 这 3 种手术方法在长期肿瘤学结果方面没有统计学差异。然而，通过贝叶斯网络分析的概率分析排名，可以得出这 3 种手术方法之间存在细微差异，即 LRC 在长期肿瘤学结果方面可能优于 RARC 或 ORC。此外，我们需要更大的样本量和更多高质量的研究来进一步改进和验证。
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