Evidence map›Paper›PMID 31773242›Full record

SynthesisWorld journal of urology2020

Robotic versus other nephroureterectomy techniques: a systematic review and meta-analysis of over 87,000 cases.

Alessandro Veccia, Alessandro Antonelli, Simone Francavilla, Claudio Simeone, Georgi Guruli, Homayoun Zargar, Sisto Perdoná, Matteo Ferro, Giuseppe Carrieri, Lance J Hampton and 2 more

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  19. Summary of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma 2023 by the Japanese Urological Association.International journal of urology : official journal of the Japanese Urological Association · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Alessandro VecciaDivision of Urology, VCU Health System, VCU Medical Center, PO Box 980118, Richmond, VA, 23298-0118, USA.
Alessandro AntonelliUrology Unit, ASST Spedali Civili Hospital, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Brescia, Italy.
Simone FrancavillaUrology Unit, ASST Spedali Civili Hospital, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Brescia, Italy.
Claudio SimeoneUrology Unit, ASST Spedali Civili Hospital, Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Brescia, Italy.
Georgi GuruliDivision of Urology, VCU Health System, VCU Medical Center, PO Box 980118, Richmond, VA, 23298-0118, USA.
Homayoun ZargarDepartment of Surgery, Department of Urology, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia.
Sisto PerdonáUro-Gynecological Department, Fondazione "G. Pascale" IRCCS, Naples, Italy.
Matteo FerroDivision of Urology, European Institute of Oncology, Milan, Italy.
Giuseppe CarrieriUrology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Lance J HamptonDivision of Urology, VCU Health System, VCU Medical Center, PO Box 980118, Richmond, VA, 23298-0118, USA.
Francesco PorpigliaDivision of Urology, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy.
Riccardo AutorinoDivision of Urology, VCU Health System, VCU Medical Center, PO Box 980118, Richmond, VA, 23298-0118, USA. ricautor@gmail.com.ORCID http://orcid.org/0000-0001-7045-7725

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo perform a systematic review and meta-analysis of the literature inherent robotic nephroureterectomy (RNU) and to compare its outcomes with those of other nephroureterectomy (NU) techniques.

methodsA systematic literature search was performed up to April 2019 using PubMed, Embase®, and Web of Science. The Preferred Reporting Items for Systematic Review and Meta-analysis Statement was followed for study selection. The following data were extracted for each study: baseline features, surgical outcomes, oncological outcomes, and survival outcomes. Stata® 15.0 was used for statistical analysis.

resultsLiterature search identified 80 studies eligible for the meta-analysis and overall 87,291 patients were included in the analysis: open NU (ONU; n = 45,601), hand-assisted laparoscopic NU (HALNU; n = 442), laparoscopic NU (LNU n = 31,093), and RNU (n = 10,155). RNU was more likely to be performed in those patients with multifocal tumor location (proportion: 0.19; 95% CI 0.14, 0.24) and high-grade disease (proportion: 0.70; 95% CI 0.53, 0.68). The lowest EBL was recorded in the RNU group (weighted mean (WM) 163.31 mL; 95% CI 88.94, 237.68), whereas the highest was in the ONU group (414.99 mL; 95% CI 378.52, 451.46). Operative time was shorter for ONU (224.98 mL; 95% CI 212.26, 237.69). RNU had lower rate of intraoperative complications (0.02; 95% CI 0.01, 0.05). ONU showed higher odds of transfusions (0.20; 95% CI 0.15, 0.25). LOS was statistically significantly shorter for the RNU group (5.35 days; 95% CI 4.97, 5.82). HALNU seemed to present lower risk of PSM (0.02; 95% CI - 0.01, 0.05), and lower risk of recurrence (0.22; 95% CI 0.15, 0.30), metastasis (0.07; 95% CI 0.05, 0.10), and cancer-related death (0.03; 95% CI 0.01, 0.06). ONU showed the lowest 5 years cancer specific survival (proportion: 0.77; 95% CI 0.74, 0.80). No correlation was found between the surgical technique and recurrence-free and cancer-specific survival.

conclusionsEvidence regarding RNU for the treatment of UTUC is increasing but it remains quite sparse and of low quality. Despite this, RNU seems to be safe, and to offer the advantages of a minimally invasive approach without impairing the oncological outcomes. Nevertheless, ONU, HALNU, and LNU still represent a valid, and commonly used surgical treatment option. As RNU becomes more popular, and concerns related to its use remain, the best surgical technique for NU remains to be determined.

Indexed as

Robotic Surgical ProceduresCarcinoma, Transitional CellHumansKidney NeoplasmsNeoplasms, Multiple PrimaryNephroureterectomySurvival RateTreatment OutcomeUreteral NeoplasmsHand-assisted radical nephroureterectomyLaparoscopic radical nephroureterectomyOpen radical nephroureterectomyRobotic radical nephroureterectomyUpper tract urothelial carcinoma

Identifiers

PMID31773242

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.