Role of TERT mutations in bladder cancer prognosis: Protocol for a systematic review and meta-analysis

Background: One of the greatest obstacles to improving long-term survival rates for bladder cancer patients is the disease's rapid recurrence rate coupled with aggressive metastatic behavior. Discovering effective prognostic markers is necessary to improve treatment results. Objective: This systematic review sets out to establish the effectiveness of TERT mutations as prognostic markers for disease free survival (DFS) and overall survival (OS) and recurrence-Free Survival (RFS) and progression-free survival (PFS) and disease-specific survival rate (DSS) of patients with bladder cancer by collating findings from various studies. Methods: Quality of selected articles will be evaluated using the Newcastle-Ottawa Scale (NOS) checklist independently by two reviewers to determine risk of bias. Differences will be sorted through a discussion with a a third reviewer. STATA 12.0 will be utilized to do the synthesis of data by estimating hazard ratios (HRs) and 95% confidence intervals (CIs) for TERT mutations. Heterogeneity will be determined by Higgins’ I^2 statistic, and where there is considerable heterogeneity a random effects model will be used. Begg’s funnel plot and Egger’s test, together with a sensitivity analysis, will carry out evaluation of the publication bias. Ethnics and dissemination: since this is a review of existing research, ethical approval is not required. The findings of this systematic review and meta-analysis will be shared through publication in a peer?reviewed journal. PROSPERO registration number: CRD42024596965