Robot-assisted vs open radical cystectomy for bladder cancer in adults
原文： 2020 年 发布于
BMC Urol
77 卷 第 51 期 4604-4618
浏览量：247次
作者：
Rai B. P.
Bondad J.
Vasdev N.
Adshead J.
Lane T.
Ahmed K.
Khan M. S.
Dasgupta P.
Guru K.
Chlosta P. L.
Aboumarzouk O. M.
作者单位：
Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. Department of Urology, Medical University of Vienna, Vienna, Austria
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Department of Urology, Medical University of Vienna, Vienna, Austria. Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland
Urological Research Institute, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan. Department for Gynaecology and Gynaecologic Oncology, Medical University of Vienna, Vienna, Austria. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. Department of Urology, Medical University of Vienna, Vienna, Austria
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
Department of Urology, Weill Cornell Medical College, New York, NY
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria. Electronic address: shahrokh.shariat@meduniwien.ac.at.
归属分类：
膀胱肿瘤治疗及预后证据
DOI：
10.4103/iju.IJU_69_21
关键词：
Cystectomy/*methods
Humans
Length of Stay
Nutritional Status
*Perioperative Care
Postoperative Complications/*epidemiology
Urinary Bladder Neoplasms/*surgery
Wound Healing
Purpose: This study aimed to investigate the effect of androgen suppression therapy (AST), comprising a 5-alpha reductase inhibitor (5-ARi) and androgen deprivation therapy (ADT), on the risk of bladder cancer incidence, recurrence, and mortality. Materials and methods: We used the PRISMA statement to report the methods and results of this meta-analysis. Bladder cancer incidence, recurrence, and mortality after 5-ARi treatment and ADT were assessed using risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs). The protocol of this study is registered in the PROSPERO database (No. CRD42018118627). Results: We analyzed nine studies (n = 377,427) assessing the secondary effect of AST, with a mean follow-up period of 6 years (range, 2-13 years). Our result showed that the incidence of bladder cancer was significantly reduced when 5-ARi treatment (RR, 0.69; 95% CI, 0.58-0.81; I-2 =0%) and ADT (HR, 0.81; 95% CI, 0.70-0.94; I-2 =33%) were initiated before diagnosing bladder cancer. When treatment was initiated after diagnosing bladder cancer, 5-ARi treatment reduced cancer-specific mortality (RR, 0.29; 95% CI, 0.20-0.42; I-2 =4.1%), whereas ADT reduced bladder cancer recurrence (HR, 0.30; 95% CI, 0.19-0.49; I-2 =0%). Conclusions: This study corroborates that the use of 5-ARi and ADT could be helpful in managing bladder cancer and should not be limited to prostatic abnormalities.