首页膀胱肿瘤治疗及预后证据详情

国内应用热灌注化疗治疗非浸润性膀胱肿瘤的疗效与安全性 Meta 分析

原文: 2021 年 发布于 World J Urol 4 卷 第 12 期 35-48 浏览量:273次 原文链接

作者: 彭康 孙晓磊 彭云鹏 陈仁富

作者单位: Department of Environmental Genomics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. Department of Urology, Huai-an First People's Hospital Affiliated to Nanjing Medical University, Huai-an, China. Department of Medical Technology, Jiangsu Vocational College of Medicine, Yancheng, China. Core Laboratory of Nantong Tumor Hospital, Nantong, China. Department of Environmental Genomics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: drzdzhang@njmu.edu.cn. Department of Environmental Genomics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China. Electronic address: chy_grape@njmu.edu.cn.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.26914/c.cnkihy.2019.073409

关键词: *Carcinoma Transitional Cell/surgery Cystectomy/adverse effects Humans Neoplasm Recurrence Local *Urinary Bladder Neoplasms/surgery

文献简介

BACKGROUND: A meta-analysis was conducted to evaluate the curative effect of radical cystectomy in the treatment of muscular invasive bladder cancer (MIBC). METHODS: Chinese and English databases were searched using free combinations of the terms `bladder cancer,` `radical cystectomy,` `muscle invasive bladder cancer,` and `bladder preservation.` Review Manager 5.3 software was used for the meta-analysis. RESULTS: A total of 12 articles were included in the meta-analysis, most of which had low-bias risk and were of medium and high quality. A funnel chart showed that the circles of some studies were basically symmetrical with the midline, suggesting that the research accuracy was high, the publications were not biased, and the final conclusions were credible. Twelve articles analyzed patients' 5-year survival rate in randomized controlled trials (RCTs). In these RCTs, the experimental group (expt group) comprised 775 cases and the control group (ctrl group) comprised 766 cases. A heterogeneity test using the fixed-effects model (FEM) showed Chi(2) =2.19, df =11, I(2)=0%, P=1.00>0.1, Z =2.57, odds ratio (OR) =1.30, 95% confidence interval (CI): 1.06-1.59, and P=0.01<0.05. 3 articles analyzed patients' 10-year survival rates in RCTs. These trials comprised a total of 417 patients (209 in the expt group and 208 in the ctrl group). The overall heterogeneity test showed Chi(2) =0.40, df =2, I(2)=0%, P=0.82>0.1, Z =1.42, OR =1.32, 95% CI: 0.90-1.94, and P=0.16>0.05. 6 articles analyzed 5-year distant metastasis rates (DMRs) in RCTs. The overall heterogeneity test showed Chi(2) =1.68, df =5, I(2)=0%, P=0.89>0.1, Z =1.70, OR =1.28, 95% CI: 0.96-1.71, and P=0.09>0.05). DISCUSSION: Our meta-analysis confirmed that radical cystectomy is effective in the treatment of MIBC and is worthy of clinical promotion.

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