Systematic review and meta-analysis of randomized controlled trials of perioperative outcomes and prognosis of transurethral en-bloc resection vs. conventional transurethral resection for non-muscle-invasive bladder cancer
原文: 2022 年 发布于
Eur Urol Focus
207 卷 第 1 期 e12988
浏览量:212次
作者:
Li Z. Y.
Zhou Z. B.
Cui Y. S.
Zhang Y.
作者单位:
Division of Experimental Oncology, Department of Urology, Urological Research Institute (URI), IRCCS San Raffaele Hospital, Milan, Italy. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy. Oncologic Minimally Invasive Urology and Andrology Unit, Careggi Hospital, Florence, Italy. Department of Urology, School of Medicine, Città della Salute e della Scienza, Turin, Italy. Department of Urology, Medical University of Vienna, Vienna, Austria. Department of Maternal Infant and Urologic Sciences, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy. Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wrocław Medical University, Wrocław, Poland. Department of Urology, University Clinics of Brussels, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium. Unit of Urology, Department of Surgical Sciences, Tor Vergata University Hospital, Tor Vergata University, Rome, Italy. Department of Urology, Puigvert Foundation, Barcelona, Spain. Department of Urology, Campus Bio-Medico University Hospital, Rome, Italy. Division of Experimental Oncology, Department of Urology, Urological Research Institute (URI), IRCCS San Raffaele Hospital, Milan, Italy - marco.moschini87@gmail.com. Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland. Clinica Luganese Moncucco, Lugano, Switzerland. Sant'Anna Clinic, Swiss Medical Group, Sorengo, Switzerland.
归属分类:
膀胱肿瘤治疗及预后证据
DOI:
10.1097/mou.0000000000001065
关键词:
Cohort Studies
*Dietary Fats/adverse effects
Female
Humans
Male
Prospective Studies
Risk Factors
Sugars
*Urinary Bladder Neoplasms/epidemiology/etiology
bladder cancer
diet
epidemiology
fat
oil
risk factor
OBJECTIVE: To determine the oncologic and toxicity outcomes of adjuvant immunotherapy with immune checkpoint inhibitors (ICIs) compared to adjuvant chemotherapy in patients treated with radical surgery for urothelial carcinoma (UC). METHODS: We used the Bayesian approach in the network meta-analysis of different therapy regimens compared to observation or placebo. RESULTS: Nine studies comprised of 2,444 patients met the eligibility criteria. In bladder UC, chemotherapy, atezolizumab, and nivolumab did not improve disease progression compared to observation/placebo. In upper tract UC (UTUC), chemotherapy was significantly associated with a lower likelihood of disease progression compared to observation/placebo, while atezolizumab and nivolumab were not. Based on the analysis of the treatment ranking, adjuvant chemotherapy appeared as the best treatment approach in both bladder UC and UTUC. The risk of adverse events with ICIs was comparable to that of observation/placebo. CONCLUSION: Our analysis suggests a superior oncologic benefit to adjuvant chemotherapy over ICIs in patients treated with radical surgery for both bladder UC and UTUC.