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01-10-2015 | Urologic Oncology

Extracapsular Extension of Pelvic Lymph Node Metastasis is an Independent Prognostic Factor in Bladder Cancer: A Systematic Review and Meta-analysis

Authors: Tae Sik Ahn, MD, Hyung Suk Kim, MD, Chang Wook Jeong, MD, PhD, Cheol Kwak, MD, PhD, Hyeon Hoe Kim, MD, PhD, Ja Hyeon Ku, MD, PhD

Published in: Annals of Surgical Oncology | Issue 11/2015

Abstract

Purpose

We aimed to elucidate the relation between extracapsular extension (ECE) and clinical outcomes in node-positive patients following radical cystectomy for bladder cancer.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed, SCOPUS, Web of Science, and Cochrane Library databases from their respective dates of inception until September 2014.

Results

Ten articles that met the eligibility criteria included 43–748 subjects per study, with the total number of patients being 1,893. The frequency of ECE ranged from 36.6 to 58.1 %. The pooled hazard ratio (HR) was statistically significant for recurrence-free survival (RFS) [pooled HR 1.56; 95 % confidence interval (CI) 1.13–2.14] and cancer-specific survival (CSS) (pooled HR 1.60; 95 % CI 1.29–1.99) but not overall survival (OS) (pooled HR 1.47; 95 % CI 0.71–3.05). Heterogeneity in RFS (I ² 84 %, p < 0.00001) and OS (I ² 80 %, p = 0.03) was statistically significant. According to subgroup analysis with meta-regression analyses, “region” (pheterogeneity < 0.0001) and “analysis results” (pheterogeneity < 0.0001) were the sources of heterogeneity. Sensitivity analysis showed that omission of any study did not lead to a significant difference. No statistical evidence of publication bias regarding RFS or CSS was revealed among the studies using Begg’s and Egger’s tests.

Conclusions

This meta-analysis shows that ECE is an efficient prognostic factor for node-positive bladder cancer. However, large prospective studies are needed to confirm the clinical utility of ECE as an independent prognostic factor before these results can be applied clinically.

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Title: Extracapsular Extension of Pelvic Lymph Node Metastasis is an Independent Prognostic Factor in Bladder Cancer: A Systematic Review and Meta-analysis
Authors: Tae Sik Ahn, MD
Hyung Suk Kim, MD
Chang Wook Jeong, MD, PhD
Cheol Kwak, MD, PhD
Hyeon Hoe Kim, MD, PhD
Ja Hyeon Ku, MD, PhD
Publication date: 01-10-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 11/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-4359-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extracapsular Extension of Pelvic Lymph Node Metastasis is an Independent Prognostic Factor in Bladder Cancer: A Systematic Review and Meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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