TY - JOUR
T1 - The role of adjuvant radiotherapy after surgery for upper and lower urinary tract urothelial carcinoma
T2 - A systematic review
AU - Iwata, Takehiro
AU - Kimura, Shoji
AU - Abufaraj, Mohammad
AU - Janisch, Florian
AU - Karakiewicz, Pierre I.
AU - Seebacher, Veronika
AU - Rouprêt, Morgan
AU - Nasu, Yasutomo
AU - Shariat, Shahrokh F.
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10
Y1 - 2019/10
N2 - Objectives: The role of adjuvant radiotherapy (ART) in patients with bladder cancer (BCa) and upper tract urothelial carcinoma (UTUC) is controversial. We systematically evaluated the oncologic efficacy of ART and its associated toxicity in patients treated with surgery and ART for BCa and UTUC. Materials and method: We performed a literature search on December 2018 using MEDLINE, Web of Science, Cochrane databases and Scopus according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Fourteen BCa studies and 14 UTUC studies were included in this systematic review. The data were too scarce and heterogeneous for meta-analytical analysis. Results: The quality and quantity of the data on ART in BCa and UTUC patients are limited. The combination of ART and chemotherapy appears to be beneficial in patients with locally advanced BCa or UTUC. The early and late adverse effects of ART are decreasing reflecting the progress in radiation technology. Conclusions: According to the currently available literature, there is no clear benefit of ART after radical surgery in BCa and UTUC. Future efforts should focus on evaluating multimodal approach using ART with chemotherapy. Until that time comes, ART should be used carefully in patients with BCa and UTUC on a case-by-case basis.
AB - Objectives: The role of adjuvant radiotherapy (ART) in patients with bladder cancer (BCa) and upper tract urothelial carcinoma (UTUC) is controversial. We systematically evaluated the oncologic efficacy of ART and its associated toxicity in patients treated with surgery and ART for BCa and UTUC. Materials and method: We performed a literature search on December 2018 using MEDLINE, Web of Science, Cochrane databases and Scopus according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Fourteen BCa studies and 14 UTUC studies were included in this systematic review. The data were too scarce and heterogeneous for meta-analytical analysis. Results: The quality and quantity of the data on ART in BCa and UTUC patients are limited. The combination of ART and chemotherapy appears to be beneficial in patients with locally advanced BCa or UTUC. The early and late adverse effects of ART are decreasing reflecting the progress in radiation technology. Conclusions: According to the currently available literature, there is no clear benefit of ART after radical surgery in BCa and UTUC. Future efforts should focus on evaluating multimodal approach using ART with chemotherapy. Until that time comes, ART should be used carefully in patients with BCa and UTUC on a case-by-case basis.
KW - Adjuvant radiotherapy
KW - Bladder cancer
KW - Recurrence
KW - Upper tract urothelial carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85067988290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067988290&partnerID=8YFLogxK
U2 - 10.1016/j.urolonc.2019.05.021
DO - 10.1016/j.urolonc.2019.05.021
M3 - Review article
C2 - 31255542
AN - SCOPUS:85067988290
SN - 1078-1439
VL - 37
SP - 659
EP - 671
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
IS - 10
ER -
