首页膀胱肿瘤治疗及预后证据详情

Comparison of health-related quality of life (HRQoL) between ileal conduit diversion and orthotopic neobladder based on validated questionnaires: a systematic review and meta-analysis

原文: 2018 年 发布于 BJU Int 52 卷 第 2 期 e0174746 浏览量:282次

作者: Shi H. Yu H. Bellmunt J. Leow J. J. Chen X. Guo C. Yang H. Zhang X.

作者单位: Department of Chemistry (Biochemistry Branch), Faculty of Science, Suez University, Suez, Egypt. mselgedamy@mans.edu.eg. Medical Biochemistry Department, National Research Center, Giza, Egypt. Division of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. Genetics Unit, Children Hospital, Mansoura University, Mansoura, Egypt. Department of Chemistry (Biochemistry Branch), Faculty of Science, Suez University, Suez, Egypt.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1007/s00345-020-03201-3

关键词: Antibiotics Antineoplastic/*therapeutic use BCG Vaccine/*therapeutic use Combined Modality Therapy Humans Mitomycin/*therapeutic use Urinary Bladder Neoplasms/*drug therapy bacillus Calmette-Guérin mitomycin C non-muscle-invasive bladder carcinoma recurrence rate meta-analysis.

文献简介

OBJECTIVE: This study aimed to comprehensively analyze the oncological long-term outcomes of trimodal therapy (TMT) and radical cystectomy (RC) for the treatment of muscle-invasive bladder cancer (BC) with or without neoadjuvant chemotherapy (NAC). PATIENTS AND METHODS: A systematic search was conducted according to the PRISMA guidelines for studies reporting on outcomes after TMT and RC. A total of 57 studies including 30,293 patients were included. The 10-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates for TMT and RC were assessed. RESULTS: The mean 10-year OS was 30.9% for TMT and 35.1% for RC (P = 0.32). The mean 10-year DSS was 50.9% for TMT and 57.8% for RC (P = 0.26). NAC was administered before therapy to 453 (13.3%) of 3,402 patients treated with TMT and 812 (3.0%) of 27,867 patients treated with RC (P<0.001). Complete response (CR) was achieved in 1,545 (75.3%) of 2,051 evaluable patients treated with TMT. A 5-year OS, DSS, and RFS after CR were 66.9%, 78.3%, and 52.5%, respectively. Downstaging after transurethral bladder tumor resection or NAC to stage ≤pT1 at RC was reported in 2,416 (29.1%) of 8,311 patients. NAC significantly increased the rate of pT0 from 20.2% to 34.3% (P = 0.007) in cT2 and from 3.8% to 23.9% (P<0.001) in cT3-4. A 5-year OS, DSS, and RFS in downstaged patients (≤pT1) at RC were 75.7%, 88.3%, and 75.8%, respectively. CONCLUSION: In this analysis, the survival outcomes of patients after TMT and RC for MIBC were comparable. Patients who experienced downstaging after NAC and RC exhibited improved survival compared to patients treated with RC only. Best survival outcomes after TMT are associated with CR to this approach.

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