Is radiotherapy helpful for the prognosis of upper urinary tract urothelial carcinoma? A meta-analysis.

BACKGROUND

At present, the guidelines of the European Society of Urology regarding the use of adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) are not clear, and there are many contradictions in previous research. In addition, several studies on the effect of radiotherapy alone on UTUC patients have been published in recent years, but their results are still inconsistent. To address these problems, we conducted the current meta-analysis.

METHOD: Articles were searched in 3 electronic databases: PubMed, Embase and the Cochrane Library. Studies were filtered according to a selection strategy, and data were extracted. Finally, Stata software was used for sensitivity analysis, and Egger's test was used to calculate the stability of the results and determine whether there was publication bias.

RESULT: In total, 17 studies involving and 25906 patients were included, adjuvant radiotherapy had no significant effect on patients with UTUC (OS: HR = 1.38 [0.94, 2.03], = P 0.10; CSS: HR = 1.43 [0.92, 2.25], P = 0.11; LRFS: HR = 1.40 [0.99, 1.98], P = 0.06; RFS: HR = 1.19 [0.52, 2.73], P = 0.68; MFS: HR = 1.37 [0.35, 5.31], P = 0.65). Radiotherapy alone had adverse effects on patients with UTUC (OS: HR = 1.25 [1.09, 1.43], P = 0.001, CSS: HR = 1.47 [1.37, 1.59], P < 0.00001).

CONCLUSION

Our results show that adjuvant radiotherapy has no significant effect on the prognosis of patients with UTUC, while radiotherapy alone will have an adverse effect on patients with UTUC. In the future, the determination of the tumor stage of patients receiving adjuvant radiotherapy may be an important research direction.