首页膀胱肿瘤治疗及预后证据详情

En Bloc Resection for Bladder Tumors: An Updated Systematic Review and Meta-Analyses of Its Differential Effect on Its Safety, Histopathology and, Recurrence

原文: 2022 年 发布于 Bladder Cancer 81 卷 第 6 期 35-48 浏览量:308次

作者: Yanagisawa T. Mori K. Motlagh R. S. Kawada T. Mostafaei H. Quhal F. Laukhtina E. Rajwa P. Konig F. Pallauf M. Pradere B. D'Andrea D. Comperat E. Miki J. Kimura T. Egawa S. Shariat S. F.

作者单位: Department of Oncology, Rigshospitalet, Blegdamsvej 9, section 5073, 2100, Copenhagen Ø, Denmark. Unit of Survivorship, Danish Cancer Society, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark. Department of Oncology, Rigshospitalet, Blegdamsvej 9, section 5073, 2100, Copenhagen Ø, Denmark. helle.pappot@regionh.dk.

归属分类: 膀胱肿瘤治疗及预后证据

DOI: 10.1080/01635581.2019.1637909

关键词: Aged Antineoplastic Combined Chemotherapy Protocols/*therapeutic use Carcinoma Transitional Cell/*drug therapy/*pathology Female Humans Immune Checkpoint Inhibitors/*therapeutic use Liver Neoplasms/secondary Male Middle Aged Survival Analysis Urinary Bladder Neoplasms/*drug therapy/*pathology bladder cancer immune checkpoint inhibitors immunotherapy meta-analysis urothelial carcinoma

文献简介

Pembrolizumab is the standard for the first and second lines in treating metastatic urothelial carcinoma (UC). This systematic review and meta-analysis aimed to assess the value of pretreatment clinical characteristics and hematologic biomarkers for prognosticating response to pembrolizumab in patients with metastatic UC. PUBMED(®), Web of Science™, and Scopus(®) databases were searched for articles published before May 2021 according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement. Studies were deemed eligible if they evaluated overall survival (OS) in patients with metastatic urothelial carcinoma treated with pembrolizumab and pretreatment clinical characteristics or laboratory examination. Overall, 13 studies comprising 1311 patients were eligible for the meta-analysis. Several pretreatment patients' demographics and hematologic biomarkers were significantly associated with worse OS as follows: Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ≥ 2 (Pooled hazard ratio [HR]: 3.24, 95% confidence interval [CI] 2.57-4.09), presence of visceral metastasis (Pooled HR: 1.84, 95% CI 1.42-2.38), presence of liver metastasis (Pooled HR: 4.23, 95% CI 2.18-8.20), higher neutrophil-lymphocyte ratio (NLR) (Pooled HR: 1.29, 95% CI 1.07-1.55) and, higher c-reactive protein (CRP) (Pooled HR: 2.49, 95% CI 1.52-4.07). Metastatic UC patients with poor PS, liver metastasis, higher pretreatment NLR and/or CRP have a worse survival despite pembrolizumab treatment. These findings might help to guide the prognostic tools for clinical decision-making; however, they should be interpreted carefully, owing to limitations regarding the retrospective nature of primary data.

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