Outcomes after radical nephroureterectomy and segmental ureterectomy in urothelial cancer of ureter : a meta-analysis

To compare the prognostic effects of segmental ureterectomy (SU) and radical nephroureterectomy (RNU) for urothelial cancer of the ureter (UUC). Databases including Pubmed, Embase and Cochrane online library were selected for systematic review of retrospective trials that comparing outcomes of SU and RNU in the patients with UUC. Interested data including hazard radio (HR) for overall survival (OS), cancer specific survival (CSS), intravesical recurrence free survival (IRFS), recurrence free survival (RFS) and metastasis free survival (MFS) were extracted by two reviewers independently from selected trials. Meta-analysis was performed using RevMan 5.3 software. Eight eligible trials evaluating SU vs RNU for UUC were identified including 895 SU cases and 2149 RNU cases. The results showed no significant difference between the two kinds of surgical methods in HR for OS (P=0.86), CSS (P=0.23), IRFS (P=0.95), RFS (P=0.17) and MFS (P=0.23). Our analysis showed that SU had equivalent prognostic effect for UUC compared with RNU, which was considered the standard method. Because of the inherent limitations of the included studies, further large sample, multi-centric studies and randomized control trials should be undertaken to confirm our findings.