首页膀胱肿瘤治疗及预后证据详情

Antimicrobial Prophylaxis for Postoperative Urinary Tract Infections in Transurethral Resection of Bladder Tumors: A Systematic Review and Meta-Analysis. Letter.J Urol 2021; 205: 987

原文: 2021 年 发布于 Cochrane Database Syst Rev 4 卷 第 15 期 815-824 浏览量:168次

作者: Rizzo M. Liguori G. Trombetta C.

作者单位: Graduate school of Health Sciences, Hokkaido University, N12-W5, Kitaku, Sapporo, Hokkaido, Japan. Department of Renal and Genitourinary Surgery Graduate School of Medicine, Hokkaido University, N14, W5, KitaKu, Sapporo, Hokkaido, Japan. Hokkaido University of Education, Art, and Sports Business, Sapporo, Hokkaido, Japan. Faculty of Health Sciences, Hokkaido University, N12-W5, Kitaku, Sapporo, Hokkaido, Japan. Department of Urology, Hokkaido Cancer Center, 3-54, Kikusui 4-2, Shiroishiku, Sapporo, Hokkaido, Japan. Institute for Health Economics and Policy, No.11 Toyo-kaiji Bldg, 1-5-11, Nishi-Shimbashi,Minato-ku, Tokyo, Japan. Faculty of Health Sciences, Hokkaido University of Science, 7-Jo 15-4-1 Maeda, Teine, Sapporo, Hokkaido, Japan. Faculty of Health Sciences, Hokkaido University, N12-W5, Kitaku, Sapporo, Hokkaido, Japan. oga@hs.hokudai.ac.jp.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.euf.2019.03.012

关键词: 非肌层浸润性膀胱肿瘤 铥激光 经尿道等离子电切 临床疗效 荟萃分析

文献简介

Background: We conducted a meta-analysis to compare the efficacy and toxicity of scheduled intravesical gemcitabine (GEM) and Bacille Calmette-Guerin (BCG) for Ta and T1 non-muscle invasive bladder cancer (NMIBC). Methods: The database search was performed in Ovid Medline, Embase, Web of Science, Cochrane Library from the commencement of the database to July 7, 2020. Trials using immediate instillation were excluded and we present the included studies in accordance with the PRISMA 2020 reporting checklist. The data extracted was analyzed using Stata 11.0 software. Results: Six studies of 466 patients comparing GEM and BCG were finally included. No significant difference was detected between GEM and BCG group in recurrence free survival [hazard ratio (HR) =0.80, 95% confidence interval (95% CI), 0.46-1.37, P=0.410], progression free survival (HR =0.82, 95% CI, 0.38-1.77, P=0.621), and total adverse events [odds ratio (OR) =0.70, 95% CI, 0.38-1.29, P=0.253). However, patients receiving GEM treatment are less likely to develop urinary adverse events, such as dysuria (OR =0.50, 95% CI, 0.29-0.87) and hematuria (OR =0.40, 95% CI, 0.18-0.91). We performed subgroup analysis and found that the effects of GEM and BCG were similar even on patients with high recurrence risk tumor. Sensitivity analysis showed the robustness of the results. Discussion: Scheduled intravesical GEM instillation has a similar effect with BCG instillation in preventing NMIBC recurrence and progression, but GEM therapy causes a lower incidence of dysuria and hematuria than BCG. GEM may be an alternative therapy for BCG. However, the results should be treated with caution due to the low to moderate quality of the included studies.

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