首页膀胱肿瘤治疗及预后证据详情

Optimal intervals for follow-up cystoscopy in non-muscle invasive bladder cancer: a systematic review regarding oncological safety

原文: 2022 年 发布于 Emergency Medicine International 61 卷 第 6 期 505-510 浏览量:242次

作者: Dreyer T. Ernst A. Jensen J. B.

作者单位: Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China, raoyf@zju.edu.cn. The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People's Republic of China. Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1080/13685538.2019.1646238

关键词: 膀胱肿瘤 卡介苗 丝裂霉素 膀胱灌注化疗

文献简介

BACKGROUND: Bladder cancer is still a burden on the world of oncology medicine, which every year affects about 3.4 million people globally with 430,000 new cases per year. It is the fourth most common cancer in men and eighth most common women malignancy in the world. This makes bladder cancer a `silent killer` and it needs appropriate treatment planning. Single immediate instillation of chemotherapy after transurethral resection of the bladder (TURB) is recommended by EAU guideline, but its use remains a controversy. OBJECTIVE: Study aimed to analyze benefit of intravesical chemotherapy following TURB in terms of recurrency of non-muscle invasive bladder cancer (NMIBC). METHODS: Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of a single instillation after TURB with TURB alone in NMIBC (pTa-pT1) patients was conducted. Studies searched throughout Medline, PubMed, Embase, and Cochrane in December 2018. Keywords were intravesical chemotherapy, combination, transurethral resection, bladder cancer. Inclusion criteria were RCT studies, subjects in study were treated single immediate chemotherapy instillation after TURB compared to TURB alone in patient with pTa-pT1 urothelial carcinoma of the bladder. Trials with additional treatment prior to first reccurence were not eligible. Studies using recurrence rate as dependent variable. From 361 studies, in total 11 studies were eligible for this meta-analysis. RESULTS: From those 11 studies, it is shown that intravesical chemotherapy using Epirubicin and Mitomycin-C following TURB showed significant decrease of recurrence rate of bladder cancer even to progression of the disease compared to TURB alone (p<0.05) with pooled Risk Ratio were 0.69 and pooled heterogeneity (I(2)) were 26.6%. CONCLUSION: This meta-analysis study showed that combination therapy of intravesical chemotherapy after TURB is superior to TURB alone in showing the recurrence rate of NMIBC.

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