Safety and efficacy of transurethral laser therapy for bladder cancer: a systematic review and meta-analysis
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
Safety and efficacy of transurethral laser therapy for bladder cancer: a systematic review and meta-analysis Yunjin Bai1†, Li Liu2†, Haichao Yuan1, Jinhong Li1, Yin Tang1, Chunxiao Pu1 and Ping Han1*
Abstract Background: Transurethral laser therapy techniques are increasingly being used in the management of bladder tumors. It has reportedly been associated with good outcomes in small case series. The objective of the present study was to review the published literature and compare transurethral laser therapy for non–muscle-invasive bladder cancer (NMIBC) and conventional transurethral resection of bladder tumor (TURBT). Methods: We performed a systematic review and meta-analysis based on randomized controlled trials (RCTs) and controlled clinical trials (CCTs) to assess the two techniques. The eligible RCTs and CCTs were identified in the following electronic databases: PubMed, the Cochrane Central Register of Controlled Trials and Embase. Results: Seven studies were included in this systematic review. The baseline characteristics of these studies are comparable. We found no statistical difference between the two techniques regarding operative time. The intra- and postoperative complications showed that the laser procedure was better than TURBT for NMIBC, including obturator nerve reflex, bladder perforation, bladder irrigation rate, duration of catheterization and length of hospital stay. In addition, the 2-year recurrence-free survival improved in the laser group than in the TURBT group. Conclusions: Our systematic review and meta-analysis suggests that laser techniques are feasible, safe, effective procedures that provide an alternative treatment for patients with NMIBC. Given that some limitations cannot be overcome, well-designed RCTs are needed to confirm our findings. Keywords: Bladder tumor, Laser surgery, Meta-analysis, Systematic review
Background Bladder cancer is one of the most common malignant diseases of the urinary tract system. According to the American Cancer Society, an estimated 74,690 new cases of bladder cancer and 15,580 bladder cancer–related deaths occurred in 2014 [1]. Approximately 75% patients with bladder cancer present with non-muscle-invasive bladder cancer (NMIBC; formerly known as superficial bladder cancer) that is confined to either the mucosa (stage Ta, carcinoma in situ) or submucosa (stage T1) [2]. The current standard treatment for NMIBC is transurethral resection of bladder tumor (TURBT), followed by adjuvant intravesical chemotherapy or immunotherapy * Correspondence: [email protected] † Equal contributors 1 Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang 37, Chengdu, Sichuan 610041, China Full list of author information is available at the end of the article
[2]. The goals of TURBT are to eradicate all visible tumors, prevent tumor recurrence and prevent progression to invasive or metastatic disease. However, when the lesions are located in the lateral bladder wall or around the uret
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