Abstract：
To identify risk factors for upper urinary tract recurrence (UUTR) in patients treated with radical cystectomy (RC) for urothelial bladder carcinoma (UBC). The PubMed, Web of Science, and Cochrane Library were searched on March 2022 to identify relevant studies according to the Preferred Reporting Items for Systematic Review (PRISMA) statement. We included studies that provided multivariate logistic regression analyses. The pooled UUTR rate was calculated using a fixed effect model. We identified 235 papers, of which seven and 6 articles, comprising a total of 8981 and 8404 UBC patients, were selected for qualitative and quantitative analyses, respectively. Overall, 418 (4.65%) patients were diagnosed with UUTR within a median time of 1.4 to 3.1 years after RC. Risk factors for UUTR were surgical margin (hazard ratio [HR] 3.41, 95% confidence interval [CI] 2.59-4.49, P < .00001), preoperative hydronephrosis (HR: 1.74, 95% CI: 1.25-2.43, P = .001), ureteral margin (HR: 4.34, 95% CI: 2.75-6.85, P < .00001), and pT stage (HR: 2.69, 95% CI: 1.37-5.27, P < .004). Incorporation of established risk factors into a clinical prediction model might aid in the decision-making process regarding the intensity and type of surveillance protocols after RC as well as help determine the pretest probability of UUTR.
摘要：
探讨根治性膀胱切除术(RC)治疗尿路上皮性膀胱癌(UBC)患者上尿路复发(UUTR)的危险因素。PubMed,WebofScience,和Cochrane图书馆于2022年3月进行了搜索，以根据系统审查首选报告项目（PRISMA）声明确定相关研究。我们纳入了提供多变量逻辑回归分析的研究。使用固定效应模型计算合并的UUTR率。我们确认了235篇论文,其中7条和6条，包括8981和8404UBC患者，被选中进行定性和定量分析，分别。总的来说,在RC后1.4至3.1年的中位时间内，有418例（4.65％）患者被诊断为UUTR。UUTR的危险因素是手术边缘（风险比[HR]3.41，95%置信区间[CI]2.59-4.49，P<.00001），术前肾积水(HR:1.74,95%CI:1.25-2.43,P=.001),输尿管边缘（HR：4.34，95%CI：2.75-6.85，P<.00001），和pT分期（HR：2.69，95%CI：1.37-5.27，P<.004）。将已建立的风险因素纳入临床预测模型可能有助于RC后有关监视协议的强度和类型的决策过程，并有助于确定UUTR的预测试概率。
