首页膀胱肿瘤治疗及预后证据详情

Rationale and Outcomes for Neoadjuvant Immunotherapy in Urothelial Carcinoma of the Bladder

原文: 2020 年 发布于 Bmc Urology 38 卷 第 7 期 20 浏览量:252次

作者: Rouanne M. Bajorin D. F. Hannan R. Galsky M. D. Williams S. B. Necchi A. Sharma P. Powles T.

作者单位: Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department for Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Urology, Jagiellonian University, Medical College, Cracow, Poland. Department of Urology and Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. sfshariat@gmail.com. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. sfshariat@gmail.com. Department of Urology, Weill Cornell Medical College, New York, NY, USA. sfshariat@gmail.com. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA. sfshariat@gmail.com.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.3390/nu13113750

关键词: Aminolevulinic Acid/*chemistry Cystoscopy/methods Humans Image Interpretation Computer-Assisted/*methods Narrow Band Imaging/methods Photosensitizing Agents/*chemistry Urinary Bladder Neoplasms/metabolism/pathology/*surgery Narrow band imaging bladder cancer diagnostic performance photodynamic diagnosis white light-guided cystoscopy

文献简介

Female patients with bladder cancer (BCa) have had more advanced disease than their male counterparts at diagnosis and have experienced worse oncologic outcomes. However, the effect of gender on the chemotherapeutic response and oncologic outcomes after radical cystectomy (RC) and perioperative chemotherapy remains to be elucidated. We performed a systematic literature search to identify eligible studies that had investigated the effect of gender on the chemotherapeutic response and oncologic outcomes after RC and perioperative chemotherapy. We identified 15 studies reported from 2008 to 2019. For the patients who had received neoadjuvant chemotherapy (NAC), female gender was not associated with a complete response (pooled odds ratio [OR], 0.94; 95% confidence interval [CI], 0.69-1.26) nor a complete or partial response (pooled OR, 0.96; 95% CI, 0.73-1.27). In addition, women experienced had less upstaging (pooled OR, 0.3; 95% CI, 0.14-0.68) at RC compared with their male counterparts. Moreover, female patients who had undergone RC and NAC were likely to have better disease recurrence and cancer-specific mortality rates than were the male patients (pooled hazard ratio [HR], 0.66 and 95% CI, 0.44-0.98; and pooled HR, 0.49 and 95% CI, 0.29-0.81, respectively). For the patients who had undergone adjuvant chemotherapy, female gender was not associated with overall mortality (pooled HR, 1.15; 95% CI, 0.7-1.89), disease recurrence (pooled HR, 0.95; 95% CI, 0.74-1.23), or cancer-specific mortality (pooled HR, 1.07; 95% CI, 0.81-1.43). Female patients with BCa seem to benefit more from NAC than do their male counterparts. This potential differential sensitivity of female BCa to cisplatin-based combination chemotherapy might help close the gender gap in BCa, suggesting that gender could be a biomarker to help select the best systemic therapy for patients with advanced BCa.

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