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

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2.	魏强, 彭国辉, 张剑, 等. 阿霉素不同衍生物膀胱灌注对预防表浅性膀胱癌术后复发效果的系统评价.中国循证医学杂志, 2004, 4(2):104-113.
3.	王宇, 魏强, 曾浩, 等. 卡介苗联合化疗药物交替膀胱灌注预防表浅性膀胱癌TURB-t术后复发的系统评价. 中国循证医学杂志, 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.	吴刚, 谷宝军. 经尿道钬激光治疗浅表性膀胱肿瘤效果的Meta分析. 中国循证医学杂志, 2011, 11(5):554-559.
10.	赵唤, 刘红耀, 余红梅, 等. 2微米激光与等离子电切治疗非肌层浸润性膀胱肿瘤疗效比较的Meta分析. 中国医药导报, 2013, 10(16):75-77.
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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.	蒋绍博, 金讯波, 赵静, 等. 经尿道KTP激光汽化术治疗浅表性膀胱肿瘤42例临床观察. 山东医药, 2006, 46(20):11-12.
16.	霍立志, 程镇, 郑忠敬,等. 经尿道绿激光汽化和经尿道电切治疗表浅性膀胱肿瘤疗效的对比观察. 临床外科杂志, 2008, 16(11):747-748.
17.	李健, 侯瑞鹏, 张志华, 等. 经尿道绿激光汽化和经尿道电切治疗经尿道电切治疗浅表性膀胱肿瘤的疗效比较. 临床泌尿外科杂志, 2010, 25(8):586-588.
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19.	葛广成, 李中兴, 冯瑞, 等. 经尿道选择性绿激光汽化术与电切术治疗膀胱表浅肿瘤的比较研究. 海南医学, 2011, 22(10):71-72.
20.	罗斌, 王博, 蒋学文. 经尿道绿激光汽化术与经尿道电切术治疗非肌层浸润性膀胱肿瘤的临床比较. 现代中西医结合杂志, 2011, 20(15):1858-1860.
21.	文永安, 赵勇, 王慕文, 等. 经尿道膀胱肿瘤直束绿激光剜除术与等离子电切术的疗效对比研究. 泌尿外科杂志(电子版), 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.	韩前河, 单中杰, 胡建庭, 等. 经尿道绿激光汽化术与双极等离子电气化术治疗浅表性膀胱肿瘤的比较研究. 中国现代医学杂志, 2015, 25(19):83-86.
24.	刘志峰, 阮政, 宋明山, 等. 经尿道绿激光汽化切除与等离子电切治疗浅表性膀胱肿瘤的疗效比较. 泌尿外科杂志(电子版), 2015, 7(3):40-42.
25.	柳坤. 经尿道膀胱肿瘤电切术与绿激光治疗非肌层侵润性膀胱癌的临床效果及预后分析. 中国继续医学教育, 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. 魏强, 彭国辉, 张剑, 等. 阿霉素不同衍生物膀胱灌注对预防表浅性膀胱癌术后复发效果的系统评价.中国循证医学杂志, 2004, 4(2):104-113.
3. 王宇, 魏强, 曾浩, 等. 卡介苗联合化疗药物交替膀胱灌注预防表浅性膀胱癌TURB-t术后复发的系统评价. 中国循证医学杂志, 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. 吴刚, 谷宝军. 经尿道钬激光治疗浅表性膀胱肿瘤效果的Meta分析. 中国循证医学杂志, 2011, 11(5):554-559.
10. 赵唤, 刘红耀, 余红梅, 等. 2微米激光与等离子电切治疗非肌层浸润性膀胱肿瘤疗效比较的Meta分析. 中国医药导报, 2013, 10(16):75-77.
11. 吴开杰, 刘丽霞, 范晋海, 等. 经尿道激光和传统电切手术治疗非肌层浸润型膀胱肿瘤的Meta分析. 现代泌尿外科杂志, 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. 蒋绍博, 金讯波, 赵静, 等. 经尿道KTP激光汽化术治疗浅表性膀胱肿瘤42例临床观察. 山东医药, 2006, 46(20):11-12.
16. 霍立志, 程镇, 郑忠敬,等. 经尿道绿激光汽化和经尿道电切治疗表浅性膀胱肿瘤疗效的对比观察. 临床外科杂志, 2008, 16(11):747-748.
17. 李健, 侯瑞鹏, 张志华, 等. 经尿道绿激光汽化和经尿道电切治疗经尿道电切治疗浅表性膀胱肿瘤的疗效比较. 临床泌尿外科杂志, 2010, 25(8):586-588.
18. 王砺, 朱红学, 陈双峰. 经尿道绿激光汽化术与TURBt治疗浅表性膀胱移行细胞癌临床效果比较. 山东医药, 2010, 50(23):77-78.
19. 葛广成, 李中兴, 冯瑞, 等. 经尿道选择性绿激光汽化术与电切术治疗膀胱表浅肿瘤的比较研究. 海南医学, 2011, 22(10):71-72.
20. 罗斌, 王博, 蒋学文. 经尿道绿激光汽化术与经尿道电切术治疗非肌层浸润性膀胱肿瘤的临床比较. 现代中西医结合杂志, 2011, 20(15):1858-1860.
21. 文永安, 赵勇, 王慕文, 等. 经尿道膀胱肿瘤直束绿激光剜除术与等离子电切术的疗效对比研究. 泌尿外科杂志(电子版), 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. 韩前河, 单中杰, 胡建庭, 等. 经尿道绿激光汽化术与双极等离子电气化术治疗浅表性膀胱肿瘤的比较研究. 中国现代医学杂志, 2015, 25(19):83-86.
24. 刘志峰, 阮政, 宋明山, 等. 经尿道绿激光汽化切除与等离子电切治疗浅表性膀胱肿瘤的疗效比较. 泌尿外科杂志(电子版), 2015, 7(3):40-42.
25. 柳坤. 经尿道膀胱肿瘤电切术与绿激光治疗非肌层侵润性膀胱癌的临床效果及预后分析. 中国继续医学教育, 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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