Safety and Efficacy of Greenlight Laser Photoselective Vaporization for Nonmuscle-Invasive Bladder Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 RENZheng-ju , YANGBo , FANGKun , RENShang-qing , LIAOJian , LIULiang-ren ,  DONGQiang

Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

DONGQiang, Email: dqiang666@163.com

Keywords：

Nonmuscle-invasive bladder tumors; Greenlight laser photoselective vaporization; Electroresection; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160068

Video：

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Objective To systematically review the safety and efficacy of greenlight laser photoselective vaporization (PV) for nonmuscle-invasive bladder tumors (NMIBTs). Methods Such databases as PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CNKI, CBM, VIP and WanFang Data were systemically searched from inception to February 2016, to collect randomized controlled trials (RCTs) investigating the efficacy and safety of greenlight PV for NMIBTs. Two reviewers independently screened literature, extracted data, assessed the risk of bias of included studies. Then RevMan 5.3 software was used for meta-analysis. Results A total of 11 RCTs involving 921 patients met the predefined criteria. The results of meta-analysis showed that: Compared with electrocautery transurethral resection and plasmakinetic resection in treating NMIBTs, greenlight PV could significantly shorten indwelling catheter time and hospital stay, decrease bladder perforation, obturator nerve reflex, blood loss rate and tumor recurrence rate; but the operative time between the greenlight PV group and the routine surgery group was not statistically different. Conclusion Current evidence shows that greenlight PV is safe and effective in treating NMIBTs. Due to the limited quality and quantity of the included studies, more large-scale high-quality studies are warranted to further assess these results.

Citation： RENZheng-ju, YANGBo, FANGKun, RENShang-qing, LIAOJian, LIULiang-ren, DONGQiang. Safety and Efficacy of Greenlight Laser Photoselective Vaporization for Nonmuscle-Invasive Bladder Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(4): 442-450. doi: 10.7507/1672-2531.20160068 Copy

1.	Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder:update 2013. Eur Urol, 2013, 64(4):639-653.
2.	魏強, 彭國輝, 張劍, 等. 阿霉素不同衍生物膀胱灌注對預防表淺性膀胱癌術后復發效果的系統評價.中國循證醫學雜志, 2004, 4(2):104-113.
3.	王宇, 魏強, 曾浩, 等. 卡介苗聯合化療藥物交替膀胱灌注預防表淺性膀胱癌TURB-t術后復發的系統評價. 中國循證醫學雜志, 2007, 7(9):650-657.
4.	Malmstrom PU, Sylvester RJ, Crawford DE, et al. An individual patient data meta-analysis of the long-term outcome of randomised studies comparing intravesical mitomycin C versus bacillus Calmette-Guerin for non-muscle-invasive bladder cancer. Eur Urol, 2009, 56(2):247-256.
5.	Nieder AM, Meinbach DS, Kim SS, et al. Transurethral bladder tumor resection:intraoperative and postoperative complications in a residency setting. J Urol, 2005, 174(6):2307-2309.
6.	Xishuang S, Deyong Y, Xiangyu C, et al. Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and holmium laser transurethral resection of primary non-muscle invasive bladder cancer. J Endourol, 2010, 24(1):69-73.
7.	Hollenbeck BK, Miller DC, Taub D, et al. Risk factors for adverse outcomes after transurethral resection of bladder tumors. Cancer, 2006, 106(7):1527-1535.
8.	Matulewicz RS, Sharma V, McGuire BB, et al. The effect of surgical duration of transurethral resection of bladder tumors on postoperative complications:An analysis of ACS NSQIP data. Urol Oncol, 2015, 33(8):338 e319-324.
9.	吳剛, 谷寶軍. 經尿道鈥激光治療淺表性膀胱腫瘤效果的Meta分析. 中國循證醫學雜志, 2011, 11(5):554-559.
10.	趙喚, 劉紅耀, 余紅梅, 等. 2微米激光與等離子電切治療非肌層浸潤性膀胱腫瘤療效比較的Meta分析. 中國醫藥導報, 2013, 10(16):75-77.
11.	吳開杰, 劉麗霞, 范晉海, 等. 經尿道激光和傳統電切手術治療非肌層浸潤型膀胱腫瘤的Meta分析. 現代泌尿外科雜志, 2015, 20(7):478-483.
12.	Tao W, Yang D, Shan Y, et al. Safety and efficacy of 120W high performance system greenlight laser vaporization for non-muscle-invasive bladder cancer. J Xray Sci Technol, 2013, 21(2):309-316.
13.	He D, Fan J, Wu K, et al. Novel green-light KTP laser en bloc enucleation for nonmuscle-invasive bladder cancer:technique and initial clinical experience. J Endourol, 2014, 28(8):975-979.
14.	Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
15.	蔣紹博, 金訊波, 趙靜, 等. 經尿道KTP激光汽化術治療淺表性膀胱腫瘤42例臨床觀察. 山東醫藥, 2006, 46(20):11-12.
16.	霍立志, 程鎮, 鄭忠敬,等. 經尿道綠激光汽化和經尿道電切治療表淺性膀胱腫瘤療效的對比觀察. 臨床外科雜志, 2008, 16(11):747-748.
17.	李健, 侯瑞鵬, 張志華, 等. 經尿道綠激光汽化和經尿道電切治療經尿道電切治療淺表性膀胱腫瘤的療效比較. 臨床泌尿外科雜志, 2010, 25(8):586-588.
18.	王礪, 朱紅學, 陳雙峰. 經尿道綠激光汽化術與TURBt治療淺表性膀胱移行細胞癌臨床效果比較. 山東醫藥, 2010, 50(23):77-78.
19.	葛廣成, 李中興, 馮瑞, 等. 經尿道選擇性綠激光汽化術與電切術治療膀胱表淺腫瘤的比較研究. 海南醫學, 2011, 22(10):71-72.
20.	羅斌, 王博, 蔣學文. 經尿道綠激光汽化術與經尿道電切術治療非肌層浸潤性膀胱腫瘤的臨床比較. 現代中西醫結合雜志, 2011, 20(15):1858-1860.
21.	文永安, 趙勇, 王慕文, 等. 經尿道膀胱腫瘤直束綠激光剜除術與等離子電切術的療效對比研究. 泌尿外科雜志(電子版), 2014, 6(3):7-10.
22.	Xu YS, Guan WM, Chen WH, et al. Comparing the Treatment Outcomes of Potassium-Titanyl-Phosphate Laser Vaporization and Transurethral Electroresection for Primary Nonmuscle-Invasive Bladder Cancer:A Prospective, Randomized Study. Laser Surg Med, 2015, 47(4):306-311.
23.	韓前河, 單中杰, 胡建庭, 等. 經尿道綠激光汽化術與雙極等離子電氣化術治療淺表性膀胱腫瘤的比較研究. 中國現代醫學雜志, 2015, 25(19):83-86.
24.	劉志峰, 阮政, 宋明山, 等. 經尿道綠激光汽化切除與等離子電切治療淺表性膀胱腫瘤的療效比較. 泌尿外科雜志(電子版), 2015, 7(3):40-42.
25.	柳坤. 經尿道膀胱腫瘤電切術與綠激光治療非肌層侵潤性膀胱癌的臨床效果及預后分析. 中國繼續醫學教育, 2015, 7(24):128-129.
26.	Marks AJ, Teichman JMH. Lasers in clinical urology:state of the art and new horizons. World J Urol, 2007, 25(3):227-233.
27.	Horasanli K, Silay MS, Altay B, et al. Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 mL:A short-term prospective randomized trial. Urology, 2008, 71(2):247-251.
28.	Kuntzman RS, Malek RS, Barrett DM, et al. Potassium-titanyl-phosphate laser vaporization of the prostate:A comparative functional and pathologic study in canines. Urology, 1996, 48(4):575-583.

1. Babjuk M, Burger M, Zigeuner R, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder:update 2013. Eur Urol, 2013, 64(4):639-653.
2. 魏強, 彭國輝, 張劍, 等. 阿霉素不同衍生物膀胱灌注對預防表淺性膀胱癌術后復發效果的系統評價.中國循證醫學雜志, 2004, 4(2):104-113.
3. 王宇, 魏強, 曾浩, 等. 卡介苗聯合化療藥物交替膀胱灌注預防表淺性膀胱癌TURB-t術后復發的系統評價. 中國循證醫學雜志, 2007, 7(9):650-657.
4. Malmstrom PU, Sylvester RJ, Crawford DE, et al. An individual patient data meta-analysis of the long-term outcome of randomised studies comparing intravesical mitomycin C versus bacillus Calmette-Guerin for non-muscle-invasive bladder cancer. Eur Urol, 2009, 56(2):247-256.
5. Nieder AM, Meinbach DS, Kim SS, et al. Transurethral bladder tumor resection:intraoperative and postoperative complications in a residency setting. J Urol, 2005, 174(6):2307-2309.
6. Xishuang S, Deyong Y, Xiangyu C, et al. Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and holmium laser transurethral resection of primary non-muscle invasive bladder cancer. J Endourol, 2010, 24(1):69-73.
7. Hollenbeck BK, Miller DC, Taub D, et al. Risk factors for adverse outcomes after transurethral resection of bladder tumors. Cancer, 2006, 106(7):1527-1535.
8. Matulewicz RS, Sharma V, McGuire BB, et al. The effect of surgical duration of transurethral resection of bladder tumors on postoperative complications:An analysis of ACS NSQIP data. Urol Oncol, 2015, 33(8):338 e319-324.
9. 吳剛, 谷寶軍. 經尿道鈥激光治療淺表性膀胱腫瘤效果的Meta分析. 中國循證醫學雜志, 2011, 11(5):554-559.
10. 趙喚, 劉紅耀, 余紅梅, 等. 2微米激光與等離子電切治療非肌層浸潤性膀胱腫瘤療效比較的Meta分析. 中國醫藥導報, 2013, 10(16):75-77.
11. 吳開杰, 劉麗霞, 范晉海, 等. 經尿道激光和傳統電切手術治療非肌層浸潤型膀胱腫瘤的Meta分析. 現代泌尿外科雜志, 2015, 20(7):478-483.
12. Tao W, Yang D, Shan Y, et al. Safety and efficacy of 120W high performance system greenlight laser vaporization for non-muscle-invasive bladder cancer. J Xray Sci Technol, 2013, 21(2):309-316.
13. He D, Fan J, Wu K, et al. Novel green-light KTP laser en bloc enucleation for nonmuscle-invasive bladder cancer:technique and initial clinical experience. J Endourol, 2014, 28(8):975-979.
14. Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8:Assessing risk of bias in included studies. In:Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available at:www.cochrane-handbook.org.
15. 蔣紹博, 金訊波, 趙靜, 等. 經尿道KTP激光汽化術治療淺表性膀胱腫瘤42例臨床觀察. 山東醫藥, 2006, 46(20):11-12.
16. 霍立志, 程鎮, 鄭忠敬,等. 經尿道綠激光汽化和經尿道電切治療表淺性膀胱腫瘤療效的對比觀察. 臨床外科雜志, 2008, 16(11):747-748.
17. 李健, 侯瑞鵬, 張志華, 等. 經尿道綠激光汽化和經尿道電切治療經尿道電切治療淺表性膀胱腫瘤的療效比較. 臨床泌尿外科雜志, 2010, 25(8):586-588.
18. 王礪, 朱紅學, 陳雙峰. 經尿道綠激光汽化術與TURBt治療淺表性膀胱移行細胞癌臨床效果比較. 山東醫藥, 2010, 50(23):77-78.
19. 葛廣成, 李中興, 馮瑞, 等. 經尿道選擇性綠激光汽化術與電切術治療膀胱表淺腫瘤的比較研究. 海南醫學, 2011, 22(10):71-72.
20. 羅斌, 王博, 蔣學文. 經尿道綠激光汽化術與經尿道電切術治療非肌層浸潤性膀胱腫瘤的臨床比較. 現代中西醫結合雜志, 2011, 20(15):1858-1860.
21. 文永安, 趙勇, 王慕文, 等. 經尿道膀胱腫瘤直束綠激光剜除術與等離子電切術的療效對比研究. 泌尿外科雜志(電子版), 2014, 6(3):7-10.
22. Xu YS, Guan WM, Chen WH, et al. Comparing the Treatment Outcomes of Potassium-Titanyl-Phosphate Laser Vaporization and Transurethral Electroresection for Primary Nonmuscle-Invasive Bladder Cancer:A Prospective, Randomized Study. Laser Surg Med, 2015, 47(4):306-311.
23. 韓前河, 單中杰, 胡建庭, 等. 經尿道綠激光汽化術與雙極等離子電氣化術治療淺表性膀胱腫瘤的比較研究. 中國現代醫學雜志, 2015, 25(19):83-86.
24. 劉志峰, 阮政, 宋明山, 等. 經尿道綠激光汽化切除與等離子電切治療淺表性膀胱腫瘤的療效比較. 泌尿外科雜志(電子版), 2015, 7(3):40-42.
25. 柳坤. 經尿道膀胱腫瘤電切術與綠激光治療非肌層侵潤性膀胱癌的臨床效果及預后分析. 中國繼續醫學教育, 2015, 7(24):128-129.
26. Marks AJ, Teichman JMH. Lasers in clinical urology:state of the art and new horizons. World J Urol, 2007, 25(3):227-233.
27. Horasanli K, Silay MS, Altay B, et al. Photoselective potassium titanyl phosphate (KTP) laser vaporization versus transurethral resection of the prostate for prostates larger than 70 mL:A short-term prospective randomized trial. Urology, 2008, 71(2):247-251.
28. Kuntzman RS, Malek RS, Barrett DM, et al. Potassium-titanyl-phosphate laser vaporization of the prostate:A comparative functional and pathologic study in canines. Urology, 1996, 48(4):575-583.

Chinese Journal of Evidence-Based Medicine

Safety and Efficacy of Greenlight Laser Photoselective Vaporization for Nonmuscle-Invasive Bladder Cancer: A Meta-analysis

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