首页膀胱肿瘤诊断证据详情

Carcinoma In Situ of the Urinary Bladder: A Systematic Review of Current Knowledge Regarding Detection, Treatment, and Outcomes

原文: 2020 年 发布于 BJU Int 35 卷 第 4 期 407-416 浏览量:252次

作者: Subiela J. D. Rodríguez Faba O. Guerrero Ramos F. Vila Reyes H. Pisano F. Breda A. Palou J.

作者单位: Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, PR China. Department of Healthy Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, PR China.

归属分类: 膀胱肿瘤诊断证据

DOI: 10.1007/s00345-020-03248-2

关键词: Cystectomy/*methods Humans *Robotic Surgical Procedures Treatment Outcome Urinary Bladder Neoplasms/*surgery Oncologic outcome Open radical cystectomy Positive surgical margin Robot-assisted radical cystectomy

文献简介

Purpose: The objective of this study was to assess the value of fluorescence in situ hybridization to predict early recurrence in patients with nonmuscle invasive bladder cancer at intermediate and high risk treated with bacillus Calmette-Guerin. Materials and Methods: We performed a systematic review using MEDLINE (R), Embase (R) and the Cochrane Library. Individual patient data from prospective observational studies of fluorescence in situ hybridization in patients treated with bacillus Calmette-Guerin were included. A 2-stage individual patient data meta-analysis was done to assess the value of fluorescence in situ hybridization to predict tumor recurrence after bacillus Calmette-Guerin induction therapy. Results: From a total of 4 studies we obtained individual data on 422 patients, of whom 408 with a median followup of 18.8 months were included in the final analysis. When fluorescence in situ hybridization was positive, the recurrence HR was 1.20 (95% CI 0.81-1.79) before bacillus Calmette-Guerin (time 0), 2.23 (95% CI 1.31-3.62) at 6 weeks (time 1), 3.70 (95% CI 2.34-5.83) at 3 months (time 2) and 23.44 (95% CI 5.26-104.49) at 6 months (time 3). Conclusions: A positive fluorescence in situ hybridization test after bacillus Calmette-Guerin correlated with higher risk of recurrent tumor. Fluorescence in situ hybridization could aid urologists in risk stratifying and counseling patients. Based on the HR and the narrowest CI the preferred timing of fluorescence in situ hybridization is 3 months after transurethral resection of bladder tumor. This is also in time for patients in whom induction therapy fails to enter clinical trials or change the treatment strategy.

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