Login to Access Video or Poster Abstract: MP78-01
Sources of Funding: none

Introduction

In the current era, the ureteroscopy (URS) has become a powerful tool to diagnose and treat patients with upper tract urothelial carcinoma (UTUC). However, there is concern that it may have a negative impact on the patients. We aim to investigate whether the URS before RNU for UTUC has impact on oncologic outcomes.

Methods

We performed a systematic literature search of PubMed, Embase, and Cochrane library for citations published prior to June 2016, describing URS performed among patients with UTUC and conducted a standard meta-analysis of survival outcomes.

Results

Our meta-analysis included eight eligible studies containing 2998 patients. The results were as follows: cancer-specific survival(CSS) (Hazard Ratio(HR) = 0.74, 95% confidence interval(CI): 0.59-0.94, P = 0.01), overall survival(OS) (HR = 0.76, 95% CI: 0.48-1.21, P = 0.24), recurrence-free survival(RFS) (HR = 0.89, 95%CI: 0.69-1.14, P = 0.37), metastasis-free survival(MFS) (HR = 1.06, 95% CI: 0.82-1.36, P = 0.66), and intravesical recurrence-free survival(IRFS) (HR = 1.54, 95% CI: 1.31-1.80, P < 0.00001). Besides, excluding the previous bladder tumor history, the results of IRFS were HR = 1.83, 95% CI: 1.55-2.15, and P < 0.00001.

Conclusions

This meta-analysis indicated that URS before RNU did not have a negative impact on CSS, OS, RFS and MFS in UTUC patients. However, patients are at higher risk for intravesical recurrence after RNU when they have undergone prior URS. Further studies are needed to assess the effects of post-URS intravesical chemotherapy on intravesical recurrence.

Funding

none