Journal
JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 18, Pages -Publisher
MDPI
DOI: 10.3390/jcm10184155
Keywords
prognosis; upper urinary tract; urothelial carcinoma; renal function; renal insufficiency
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The study revealed a close association between preoperative renal function and survival outcomes in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy, with poorer preoperative renal function correlating with lower survival rates.
Preoperative renal function is associated with worse outcomes in patients undergoing radical nephroureterectomy (RNU). The purpose of this systemic review and meta-analysis was to determine the association of preoperative renal function with oncological outcome in patients who underwent RNU. We searched articles published up to March 2021 in PubMed, Scopus, and Embase by combining urothelial carcinoma, radical nephroureterectomy, and estimated glomerular filtration rate. We also manually screened the reference list for publications following general guidelines recommended by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The relationship between preoperative renal function and survival was expressed as overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS). This review and meta-analysis included 13 studies involving a total of 4668 patients who received RNU. Pooled analysis showed significant negative association of preoperative renal function with PFS (HR: 1.51, 95% CI: 1.23-1.80, p < 0.00001), CSS (HR: 1.63, 95% CI: 1.38-1.92, p < 0.00001), and OS (HR: 1.22, 95% CI: 1.10-1.35, p < 0.00001). Patients with upper tract urothelial carcinoma (UTUC) who received RNU showed a significant negative association of preoperative renal function with survival.
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