Study Type – Diagnostic (systematic review)
Level of Evidence 1a
What's known on the subject? and What does the study add?
It was well known that FL‐guided TURBT could reduce the residual rate of NMIBC, but our systematic review suggested that it was not superior to conventional WL‐guided TURBT in diagnostic accuracy and it had no significant effect on short‐term RFS and PFS.
OBJECTIVE
METHODS
- •
A systematic search of PUBMED, EMBASE and Cochrane Library was performed to identify randomized controlled trials comparing the outcomes of FL‐ and white‐light (WL)‐guided TUR of bladder tumours (TURBT).
- •
Outcomes included tumour detection rate, false‐positive diagnosis rate, carcinoma in situ (CIS) detection rate, residual tumour rate, recurrence‐free survival (RFS) and progression‐free survival (PFS).
- •
RevMan 5.1 software was used for the meta‐analysis.
RESULTS
- •
Data from 14 studies, involving 4078 patients with suspected or proven NMIBC, were pooled and included in the meta‐analysis.
- •
There was no significant difference in tumour detection rate (relative risk [RR] 0.99; 95% confidence interval [CI] 0.96–1.03; P= 0.64) and CIS detection rate (RR 0.82; 95% CI 0.67–1.02; P= 0.07) between the FL and the WL groups.
- •
The false‐positive diagnosis rate of the FL group was higher than that of the WL group (RR 0.69; 95% CI 0.49–0.97; P= 0.03).
- •
The tumour residual rate was higher in the WL group than in the FL group (RR 2.77; 95% CI 1.47–5.02; P= 0.002).
- •
No significant differences were found between groups at 3‐month follow‐up (RR 1.15; 95% CI 0.79–1.66; P= 0.46) or 12‐month follow‐up (RR 0.86; 95% CI 0.70–1.06; P= 0.16) or in terms of either RFS or PFS at 12‐month (RR 0.99; 95% CI 0.94–1.04; P= 0.57) and 24‐month follow‐up (RR 1.02; 95% CI 0.98–1.06; P= 0.35).
CONCLUSION