Objective:To conduct a meta-analysis assessing the perioperative,functional and oncological outcomes of partial nephrectomy(PN)and radical nephrectomy(RN)for T1b tumours.The primary endpoints were the oncological outc...Objective:To conduct a meta-analysis assessing the perioperative,functional and oncological outcomes of partial nephrectomy(PN)and radical nephrectomy(RN)for T1b tumours.The primary endpoints were the oncological outcomes.The secondary endpoints were the perioperative and functional outcomes.Methods:A systematic literature review was performed by searching multiple databases through February 2019 to identify eligible comparative studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement.Identified reports were assessed according to the Newcastle-Ottawa Scale for nonrandomized controlled trials.Results:Overall,13 retrospective cohort studies were included in the analysis.Patients undergoing PN were younger(weighted mean difference[WMD]3.49 years,95%confidence interval[CI]5.16 to1.82;p<0.0001)and had smaller masses(WMD0.45 cm,95%CI0.59 to0.31;p<0.0001).There were no differences in the oncological outcome,which was demonstrated by progression-free survival(hazard ratio[HR]0.70;pZ0.22),cancerspecific mortality(HR 0.91;pZ0.57)and all-cause mortality(HR 1.01;pZ0.96).The two procedures were similar in estimated blood loss(WMD16.47 mL;pZ0.53)and postoperative complications(risk ratio[RR]1.32;pZ0.10),and PN provided better renal function preservation and was related to a lower likelihood of chronic kidney disease onset(RR 0.38;pZ0.006).Conclusion:PN is an effective treatment for T1b tumours because it offers similar surgical morbidity,equivalent cancer control,and better renal preservation compared to RN.展开更多
文摘Objective:To conduct a meta-analysis assessing the perioperative,functional and oncological outcomes of partial nephrectomy(PN)and radical nephrectomy(RN)for T1b tumours.The primary endpoints were the oncological outcomes.The secondary endpoints were the perioperative and functional outcomes.Methods:A systematic literature review was performed by searching multiple databases through February 2019 to identify eligible comparative studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement.Identified reports were assessed according to the Newcastle-Ottawa Scale for nonrandomized controlled trials.Results:Overall,13 retrospective cohort studies were included in the analysis.Patients undergoing PN were younger(weighted mean difference[WMD]3.49 years,95%confidence interval[CI]5.16 to1.82;p<0.0001)and had smaller masses(WMD0.45 cm,95%CI0.59 to0.31;p<0.0001).There were no differences in the oncological outcome,which was demonstrated by progression-free survival(hazard ratio[HR]0.70;pZ0.22),cancerspecific mortality(HR 0.91;pZ0.57)and all-cause mortality(HR 1.01;pZ0.96).The two procedures were similar in estimated blood loss(WMD16.47 mL;pZ0.53)and postoperative complications(risk ratio[RR]1.32;pZ0.10),and PN provided better renal function preservation and was related to a lower likelihood of chronic kidney disease onset(RR 0.38;pZ0.006).Conclusion:PN is an effective treatment for T1b tumours because it offers similar surgical morbidity,equivalent cancer control,and better renal preservation compared to RN.
