Role of urinary tract infection in bladder cancer: a systematic review and meta-analysis
作者：
Bayne C. E.
Farah D.
Herbst K. W.
Hsieh M. H.
作者单位：
Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Medical University of Vienna, Vienna, Austria. Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland. Department of Urology, Medical University of Vienna, Vienna, Austria
Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Department of Urology, Medical University of Vienna, Vienna, Austria
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Urology, Medical University of Vienna, Vienna, Austria
Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Division of Urology, Department of Surgical Sciences, University of Studies of Torino, Turin, Italy. Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, UK. Department of Urology, Medical University of Vienna, Vienna, Austria
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
Department of Urology, Weill Cornell Medical College, New York, NY, USA
Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
European Association of Urology Research Foundation, Arnhem, Netherlands. Electronic address: shahrokh.shariat@meduniwien.ac.at.
归属分类：
膀胱肿瘤病因/危险因素证据
DOI：
10.12114/j.issn.1007-9572.2021.01.201
PURPOSE: To perform a comprehensive comparison of overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS), and treatment-related complications between radical cystectomy (RC) and combined modality treatment (CMT-radiation therapy, concurrent chemotherapy, and maximal transurethral resection of bladder tumor) in the setting of muscle-invasive bladder cancer. METHODS AND MATERIALS: We searched 7 databases (PubMed, Scopus, EMBASE, Proquest, CINAHL, and ClinicalTrials.gov) for randomized, controlled trials and prospective and retrospective studies directly comparing RC with CMT from database inception to March 2016. We conducted meta-analyses evaluating OS, DSS, and PFS with hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Nineteen studies evaluating 12,380 subjects were selected. For the 8 studies encompassing 9554 subjects eligible for meta-analyses, we found no difference in OS at 5 years (HR 0.96, favoring CMT, 95% CI 0.72-1.29; P=.778) or 10 years (HR 1.02, favoring cystectomy, 95% CI 0.73-1.42; P=.905). No difference was observed in DSS at 5 years (HR 0.83, favoring radiation, 95% CI 0.54-1.28; P=.390) or 10 years (HR 1.17, favoring cystectomy, 95% CI 0.89-1.55; P=.264), or PFS at 10 years (HR 0.85, favoring CMT, 95% CI 0.43-1.67; P=.639). The cystectomy arms had higher rates of early major complications, whereas rates of minor complications were similar between the 2 treatments. CONCLUSION: Current meta-analysis reveals no differences in OS, DSS, or PFS between RC and CMT. Further randomized, controlled trials are necessary to identify the optimal treatment for specific patients.