首页膀胱肿瘤治疗及预后证据详情

The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

原文: 2022 年 发布于 Int J Urol 86 卷 第 1 期 2901-2910 浏览量:274次

作者: Zhou W. Liu J. Mao D. Hu C. Gao D.

作者单位: Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples `Federico II`, 80121 Naples, Italy. Department of Precision Medicine, University of Campania `Luigi Vanvitelli`, 80138 Naples, Italy. Department of Medicine and Health Sciences `V. Tiberio`, University of Molise, 86100 Campobasso, Italy. Oncology Unit, Hospital 'Andrea Tortora', ASL Salerno, 84016 Pagani, Italy. Associazione O.R.A., Somma Vesuviana, 80049 Naples, Italy. Andrology and Urogynecology Clinic, Santa Maria Terni Hospital, University of Perugia, 05100 Terni, Italy. Division of Urology, European Institute of Oncology IRCCS, 20141 Milan, Italy. Division of Laboratory Medicine, Civil Hospital 'Maria SS. Addolorata', ASL Salerno, 84025 Eboli, Italy. Urology Unit, Department of Woman Child and of General and Specialist Surgery, University of Campania `Luigi Vanvitelli`, Via S. Pansini 5, 80131 Naples, Italy.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1111/bju.15383

关键词: Antibodies Monoclonal Humanized/*therapeutic use *Carcinoma Transitional Cell/drug therapy Humans Prognosis Retrospective Studies *Urinary Bladder Neoplasms/drug therapy Metastatic urothelial carcinoma Pembrolizumab Prognostic factor Janssen and Pfizer. Takahiro Kimura is a paid consultant/advisor of Astellas Bayer Janssen and Sanofi. Shahrokh F. Shariat is a paid as follows: Honoraria: Astellas AstraZeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen. Consulting or Advisory Role: Astellas AstraZeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen. Speakers Bureau: Astellas Astra Zeneca Bayer BMS Cepheid Ferring Ipsen Janssen Lilly MSD Olympus Pfizer Pierre Fabre Richard Wolf Roche Sanochemia Sanofi Takeda Urogen Movember Foundation. The other authors declare no conflicts of interest associated with this manuscript.

文献简介

BACKGROUND: This review and meta-analysis aimed to systematically evaluate the clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C (MMC) in patients with nonmuscular invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). METHODS: The Embase, PubMed, CNKI, CBM, WANGFANG, VIP, Cochrane Library, and Clinicaltrial.com databases were searched for articles published before April 2022. The experimental group was treated with intravesical instillation of MMC assisted by equipment, including radiofrequency-induced thermochemotherapy, conductive thermochemical therapy, electromotive drug administration, or locoregional hyperthermia. The control group was treated with simple MMC perfusion. The outcomes of interest in the meta-analysis were recurrence, progression, side-effects, gross haematuria, and bladder irritation. RESULTS: A total of 15 studies that enrolled 1,190 patients were included in the meta-analysis. Compared to that of the control group, device-assisted intravesical instillation of MMC significantly reduced both tumour recurrence (odds ratio [OR] = 0.32, 95% confidence interval [CI] [0.24, 0.42], P <0.00001) and progression (OR = 0.29, 95% CI [0.12, 0.67], P = 0.004). There were no significant differences between the two groups in terms of safety (OR = 1.21, 95% CI [0.66,2.21], P = 0.54), bladder irritation (OR = 1.06, 95% CI [0.72,1.55], P = 0.78), or gross haematuria (OR = 1.11, 95% CI [0.64,1.94], P = 0.72). CONCLUSIONS: Equipment-assisted intravesical instillation of MMC significantly reduced the recurrence and progression of patients with NMIBC who underwent TURBT and improved their quality of life. Given the significant heterogeneity in research quality and sample size among earlier studies, more prospective, multicentre, large sample randomized controlled trials are needed to supplement and verify this in the future.

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