| Purpose: At present,neoadjuvant chemotherapy(NAC)in the treatment of upper tract urothelial carcinoma(UTUC)is still controversial.This study has a comprehensive search and meta-analysis of the published clinical studies on the evaluation of neoadjuvant chemotherapy in the treatment of upper tract urothelial carcinoma.Methods: Relevant documents and data are collected from PubMed,EMBASE,Cochrane Library,CNKI,Wanfang data and other databases.We used Revman 5.3 statistical software for meta-analysis.The main evaluation indexes were overall survival(OS),cancer-specific survival(CSS),progression free survival(PFS)and downstaging.Results: This study included 6 retrospective studies,a total of 606 patients.The meta-analysis showed that overall survival(OS)(HR = 0.44,95% CI: 0.32-0.59,P < 0.00001),cancer-specific survival time(CSS)(HR= 0.44,95% CI = 0.26-0.73,P = 0.001),progression free survival time(PFS)(HR = 0.44,95% CI = 0.28-0.69,P = 0.0003)and downstaging(OR=4.63,95% CI = 2.64-6.80,P < 0.00001)in NAC group.There was no significant heterogeneity between the studies.Conclusion:Neoadjuvant chemotherapy can increase the overall survival(OS),cancer-specific survival time(CSS),progression free survival time(PFS)and downstaging of patients with UTUC compared with surgery alone.Patients can get better survival effect.However,prospective randomized studies are needed to further confirm the efficacy of neoadjuvant chemotherapy in patients with UTUC. |
