Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review
Background: Repeat transurethral resection of bladder tumour (reTURB) is a conventional treatment for non-muscle-invasive bladder cancer (NMIBC) to enhance prognosis. However, the necessity of reTURB in NMIBC remains controversial owing to upstaging of treatments and new evidence. Objectives: We per...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-11-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359241298470 |
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| author | Qing-Xin Yu Rui-Cheng Wu Zhou-Ting Tuo Wei-Zhen Zhu Jie Wang Xing Ye Koo Han Yoo Wu-Ran Wei De-Chao Feng Deng-Xiong Li |
| author_facet | Qing-Xin Yu Rui-Cheng Wu Zhou-Ting Tuo Wei-Zhen Zhu Jie Wang Xing Ye Koo Han Yoo Wu-Ran Wei De-Chao Feng Deng-Xiong Li |
| author_sort | Qing-Xin Yu |
| collection | DOAJ |
| description | Background: Repeat transurethral resection of bladder tumour (reTURB) is a conventional treatment for non-muscle-invasive bladder cancer (NMIBC) to enhance prognosis. However, the necessity of reTURB in NMIBC remains controversial owing to upstaging of treatments and new evidence. Objectives: We performed an umbrella review to determine the need for reTURB in patients with NMIBC. Design: We extracted data from meta-analyses that were screened out after a systematic search of PubMed, Embase, the Web of Science and the Cochrane Database of Systematic Reviews. Methods: Risk of Bias in Systematic Reviews and the Grading of Recommendations, Assessment, Development and Evaluation tools were used to assess the quality of each included meta-analysis and outcomes. Results: Our study included seven meta-analyses. Two studies assessed the efficiency of reTURB in patients who underwent en bloc resection of bladder tumours (ERBT). Patients who underwent ERBT reported low residual tumour and upstaging rates of 5.9% and 0.3%, respectively. Conversely, patients who underwent conventional transurethral resection for bladder cancer (cTURB) had high residual tumour rates. Patients who underwent cTURB and reTURB had significantly improved 1-year recurrence-free survival (RFS) compared to those who underwent initial cTURB alone. In terms of progression-free survival (PFS), a meta-analysis reported that patients who underwent cTURB and reTURB had significantly improved PFS compared with those who underwent initial cTURB alone. In the subgroup analyses of ERBT, reTURB did not affect the RFS and PFS of patients who received ERBT. Currently, only a limited number of randomised clinical trials have evaluated reTURB, and various factors have influenced its efficacy. Conclusion: There was significant variation in survival outcomes among patients undergoing reTURB. The necessity and efficacy of reTURB depend on numerous factors, such as surgical approach, equipment and medication usage. Patients eligible for ERBT may constitute a group that does not require reTURB. Further clinical trials are required to validate these findings. Registration: This umbrella review was registered with the International Prospective Register of Systematic Reviews (CRD42023439078). |
| format | Article |
| id | doaj-art-37b06552c3e74bc2805d506ec56a077f |
| institution | Kabale University |
| issn | 1758-8359 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj-art-37b06552c3e74bc2805d506ec56a077f2024-11-16T14:06:47ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592024-11-011610.1177/17588359241298470Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella reviewQing-Xin YuRui-Cheng WuZhou-Ting TuoWei-Zhen ZhuJie WangXing YeKoo Han YooWu-Ran WeiDe-Chao FengDeng-Xiong LiBackground: Repeat transurethral resection of bladder tumour (reTURB) is a conventional treatment for non-muscle-invasive bladder cancer (NMIBC) to enhance prognosis. However, the necessity of reTURB in NMIBC remains controversial owing to upstaging of treatments and new evidence. Objectives: We performed an umbrella review to determine the need for reTURB in patients with NMIBC. Design: We extracted data from meta-analyses that were screened out after a systematic search of PubMed, Embase, the Web of Science and the Cochrane Database of Systematic Reviews. Methods: Risk of Bias in Systematic Reviews and the Grading of Recommendations, Assessment, Development and Evaluation tools were used to assess the quality of each included meta-analysis and outcomes. Results: Our study included seven meta-analyses. Two studies assessed the efficiency of reTURB in patients who underwent en bloc resection of bladder tumours (ERBT). Patients who underwent ERBT reported low residual tumour and upstaging rates of 5.9% and 0.3%, respectively. Conversely, patients who underwent conventional transurethral resection for bladder cancer (cTURB) had high residual tumour rates. Patients who underwent cTURB and reTURB had significantly improved 1-year recurrence-free survival (RFS) compared to those who underwent initial cTURB alone. In terms of progression-free survival (PFS), a meta-analysis reported that patients who underwent cTURB and reTURB had significantly improved PFS compared with those who underwent initial cTURB alone. In the subgroup analyses of ERBT, reTURB did not affect the RFS and PFS of patients who received ERBT. Currently, only a limited number of randomised clinical trials have evaluated reTURB, and various factors have influenced its efficacy. Conclusion: There was significant variation in survival outcomes among patients undergoing reTURB. The necessity and efficacy of reTURB depend on numerous factors, such as surgical approach, equipment and medication usage. Patients eligible for ERBT may constitute a group that does not require reTURB. Further clinical trials are required to validate these findings. Registration: This umbrella review was registered with the International Prospective Register of Systematic Reviews (CRD42023439078).https://doi.org/10.1177/17588359241298470 |
| spellingShingle | Qing-Xin Yu Rui-Cheng Wu Zhou-Ting Tuo Wei-Zhen Zhu Jie Wang Xing Ye Koo Han Yoo Wu-Ran Wei De-Chao Feng Deng-Xiong Li Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review Therapeutic Advances in Medical Oncology |
| title | Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review |
| title_full | Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review |
| title_fullStr | Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review |
| title_full_unstemmed | Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review |
| title_short | Role of repeat transurethral resection in no-muscle-invasive bladder tumour: an umbrella review |
| title_sort | role of repeat transurethral resection in no muscle invasive bladder tumour an umbrella review |
| url | https://doi.org/10.1177/17588359241298470 |
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