首页膀胱肿瘤治疗及预后证据详情

Safety and efficacy of en bloc transurethral resection versus conventional transurethral resection for primary nonmuscle-invasive bladder cancer: a meta-analysis

原文: 2020 年 发布于 Curr Urol 40 卷 第 9 期 28-35 浏览量:214次

作者: Zhang D. Yao L. F. Yu S. Cheng Y. Jiang J. H. Ma Q. Yan Z. J.

作者单位: Department of Breast Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1002/jcla.23765

关键词: Cystectomy/methods/*mortality Humans Lymph Node Excision/methods/*mortality Lymph Nodes/surgery Lymphatic Metastasis Pelvis/pathology Postoperative Complications/etiology Prognosis Randomized Controlled Trials as Topic Survival Rate Treatment Outcome Urinary Bladder Neoplasms/*mortality/pathology/*surgery

文献简介

BACKGROUND: Recent interest has been geared towards the potential therapeutic and chemopreventive benefit of androgen deprivation therapy (ADT) for bladder cancer. As a result, several observational studies have investigated this potential association. Given the important side effects associated with ADT treatment, understanding the methodological strengths and weaknesses of the current evidence is warranted. OBJECTIVES: The objective of this systematic review was to examine the heterogeneity of the current observational studies on the association between ADT and bladder cancer by assessing the methodological strengths and limitations of these studies. MATERIAL AND METHODS: We systematically searched Medline, EMBASE, Healthstar, Cochrane Library Online, Science Citation Index, and Dissertation Abstracts Online, from inception to August 2019 to identify all observational studies investigating the association between ADT and bladder cancer. We assessed overall study quality using the ROBINS-I tool and evaluated the presence of other key pharmacoepidemiologic biases. RESULTS: Overall, our systematic review included 7 observational studies. Five studies reported a decreased risk of bladder cancer with ADT use, 1 study reported no association, and 1 study reported an increased risk. All studies had time-related biases, did not consider a lag period, and had potential residual confounding. Moreover, 1 study had potential detection bias, 6 included prevalent users, 3 had inadequate follow-up durations, 6 had exposure misclassification, and 5 used an inappropriate comparator. CONCLUSION: Taken together, future methodologically-rigorous studies addressing the limitations underlined in this systematic review are needed to evaluate the important potential association between ADT and bladder cancer.

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