Academic Journal
A systematic review and meta-analysis of clinicopathologic factors associated with adverse oncologic outcomes in bladder cancer patients undergoing radical cystectomy: Evidence from multivariable survival prediction models.
| Τίτλος: | A systematic review and meta-analysis of clinicopathologic factors associated with adverse oncologic outcomes in bladder cancer patients undergoing radical cystectomy: Evidence from multivariable survival prediction models. |
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| Συγγραφείς: | Artiles Medina A; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain. Electronic address: alberc.artiles@gmail.com., Subiela JD; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Muriel García A; Clinical Biostatistics Unit, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERESP, University of Alcalá, Madrid, Spain., Domínguez Gutiérrez A; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Gómez Dos Santos V; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Álvarez Díaz N; Library, Hospital Universitario Ramón Y Cajal (IRYCIS), Madrid, Spain., Tagalos Muñoz A; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., López Curtis D; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Mínguez Ojeda C; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., de la Parra Sánchez I; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Crespo L; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Coloma Del Peso A; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain., Burgos Revilla FJ; Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), University of Alcalá, Madrid, Spain. |
| Πηγή: | Urologic oncology [Urol Oncol] 2026 Jul; Vol. 44 (7), pp. 258-271. Date of Electronic Publication: 2026 May 05. |
| Τύπος έκδοσης: | Journal Article; Systematic Review; Meta-Analysis; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 9805460 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2496 (Electronic) Linking ISSN: 10781439 NLM ISO Abbreviation: Urol Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2003- : Philadelphia, PA : Elsevier Original Publication: New York, NY : Elsevier Science |
| Ιατρικοί όροι (MeSH): | Urinary Bladder Neoplasms*/surgery , Urinary Bladder Neoplasms*/mortality , Urinary Bladder Neoplasms*/pathology , Cystectomy*/methods, Humans ; Prognosis |
| Περίληψη: | This systematic review aimed to identify robust clinicopathologic predictors of overall (OS), cancer-specific (CSS), and recurrence-free survival (RFS) following radical cystectomy (RC) from published prediction models. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) recommendations were followed, and the study was registered in PROSPERO (CRD42024509410). MEDLINE (Ovid) and Embase (Elsevier) were searched from inception to January 2024 for studies developing or validating multivariable prediction models in patients undergoing RC for non-metastatic bladder cancer. Data were extracted following the CHARMS checklist, and risk of bias was assessed using the PROBAST (Prediction model Risk Of Bias Assessment) tool. Pooled hazard ratios (HRs) were estimated with DerSimonian-Laird random-effects models. Seventy-seven studies involving survival models met the inclusion criteria: 36 for OS, 44 for CSS, and 26 for RFS. For OS, adverse predictors included advanced age (HR 1.03, 95% confidence interval [CI] 1.02-1.04), gender (female) (HR 1.08, 95% CI 1.01-1.14), higher pathologic T stage, lymph node involvement (HR 1.91, 95% CI 1.70-2.14), lymphovascular invasion (LVI) (HR 1.49, 95% CI 1.40-1.58), positive surgical margins (HR 1.74, 95% CI 1.46-2.06), and concomitant carcinoma in situ (HR 1.09, 95% CI 1.03-1.16). Neoadjuvant (HR 0.66, 95% CI 0.47-0.93) and adjuvant chemotherapy (HR 0.74, 95% CI 0.71-0.76) and compliance with pentafecta criteria (HR 0.49, 95% CI 0.30-0.79) were associated with improved OS. CSS displayed similar prognostic patterns, with additional associations for lymph node density, hydronephrosis, sarcopenia, and elevated neutrophil-lymphocyte ratio. This meta-analysis identified consistent clinicopathologic predictors of adverse oncological outcomes after RC for bladder cancer. Systematic assessment of these variables allows more accurate postoperative prognostic stratification and supports clinical decision-making regarding adjuvant treatment selection, surveillance intensification, and patient counseling. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Cystectomy; Nomograms; Prognosis; Survival; Urinary bladder neoplasms |
| Entry Date(s): | Date Created: 20260505 Date Completed: 20260613 Latest Revision: 20260616 |
| Update Code: | 20260617 |
| DOI: | 10.1016/j.urolonc.2026.03.003 |
| PMID: | 42086443 |
| Βάση Δεδομένων: | MEDLINE |
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