首页膀胱肿瘤治疗及预后证据详情

Association between vascular endothelial growth factor rs699947 polymorphism and the risk of three major urologic neoplasms (bladder cancer, prostate cancer, and renal cell carcinoma): A meta-analysis involving 11,204 subjects

原文: 2018 年 发布于 World J Urol 52 卷 第 45 期 63-63 浏览量:193次

作者: Song Y. Hu J. Chen Q. Guo J. Zou Y. Zhang W. Chen X. Hu W. Huang P.

作者单位: Department of Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK. Electronic address: beth.russell@kcl.ac.uk. Department of Urology, Skåne University Hospital, Malmö, Sweden Institution of Translational Medicine, Lund University, Malmö, Sweden. Department of Urology, Guy's and St Thomas' NHS Foundation Trust, London, UK. The Royal Marsden NHS Foundation Trust, London, UK. Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK. Department of Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King's College London, London, UK.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1016/j.acuroe.2020.09.009

关键词: Humans Odds Ratio Pesticides/*adverse effects Risk Urinary Bladder Neoplasms/*chemically induced/epidemiology bladder cancer epidemiology meta-analysis pesticide exposure

文献简介

CONTEXT: The incidence of muscle invasive bladder cancer (MIBC) increases with age. With increased life expectancy the number of elderly MIBC patients is expected to increase. Existing guidelines on management of MIBC do not preclude curative treatments for elderly patients. However, it is necessary to assess the risks and benefits of a treatment to avoid overtreatment that results in decreased health-related quality of life without prolonging survival. OBJECTIVE: To report on overall survival (OS), cancer specific survival (CSS), and morbidity after curative treatment in elderly patients, defined as age >70 yr, with nonmetastatic MIBC and to compare this with the outcome of younger MIBC patients. EVIDENCE ACQUISITION: A systematic review was performed using Medline, PubMed, and Embase databases. Articles were included if they addressed one of the three research questions: Only articles including >100 patients and with a clear age-stratification were included. EVIDENCE SYNTHESIS: Forty-two articles were retrieved for review. No article directly addressed the use of geriatric assessment. OS and CSS worsen significantly with age both after radical cystectomy and radiotherapy regimens. While POM significantly increases with age, morbidity seems comparable between younger and older patients. CONCLUSIONS: Although a proportion of elderly patients with MIBC will benefit from curative treatment, we observed worse OS, CSS, and POM with age. The impact of age on late morbidity is less clear. Prospective studies evaluating geriatric assessments are critically needed to optimize MIBC management in the elderly. PATIENT SUMMARY: We performed a systematic review to evaluate the outcome and complication rate in elderly patients with muscle invasive bladder cancer. We observed that overall survival and cancer specific survival significantly decrease and perioperative mortality significantly increases with age. The impact of age on late morbidity is less clear. There is a need for geriatric assessments to select those patients that will benefit from curative treatment.

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