Oncological and functional outcomes of organ-preserving cystectomy versus standard radical cystectomy: A systematic review and meta-analysis.
continence
cystectomy
functional
oncological
organ sparing
radical
review
sexual
urology
Journal
BJUI compass
ISSN: 2688-4526
Titre abrégé: BJUI Compass
Pays: United States
ID NLM: 101764975
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
26
05
2022
revised:
04
08
2022
accepted:
14
08
2022
entrez:
23
2
2023
pubmed:
24
2
2023
medline:
24
2
2023
Statut:
epublish
Résumé
Radical cystectomy (RC) is historically considered the gold standard treatment for muscle invasive and high-risk non-muscle invasive bladder cancer. However, this technique leaves the majority of patients of both sexes with poor sexual and urinary function. Organ-sparing cystectomy (OSC) techniques are emerging as an alternative to the standard procedure to preserve these functions, without compromising the oncological outcomes. We present a systematic review and meta-analysis of the published literature. MEDLINE, Embase and Web of Science were systematically searched for eligible studies on 6 April 2021. Primary outcomes studied were both oncological outcomes, specifically overall recurrence, and functional outcomes, specifically sexual function, and daytime and nighttime continence. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. The PROSPERO registration reference number was CRD42018118897. From 13 894 identified abstracts, 19 studies (1886 male and 305 female patients) were eligible for inclusion in this review. These studies included patients who underwent either whole prostate, prostate capsule, seminal vesicle, nerve, uterus, ovary, vagina and fallopian tube sparing techniques. Four studies included only female patients.Thirteen studies reported oncological outcomes, and overall recurrence rate was similar between the two groups (five studies; OR 0.73; 95% CI 0.38-1.40, In carefully selected patients, OSC allows the potential to provide better sexual and urinary function without compromising oncological outcomes. There remains, however, a paucity of OSC studies in females. Further studies are required to make recommendations based on robust clinical evidence.
Identifiants
pubmed: 36816151
doi: 10.1002/bco2.189
pii: BCO2189
pmc: PMC9931545
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
135-155Informations de copyright
© 2022 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.
Déclaration de conflit d'intérêts
All authors declare no conflicts of interest as per the ICMJE COI.
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