Sub-Staging-Specific Differences in Recurrence-Free, Progression-Free, and Cancer-Specific Survival for Patients with T1 Bladder Cancer: A Systematic Review and Meta-Analysis

原文： 2020 年发布于现代泌尿生殖肿瘤杂志 39 卷第 4 期 3508-3511  浏览量：248次

作者： Chen G. Q. Yang T. Shao Q. Y. Zhang M. Z. Yang B. Zhang P. Fan J. H.

作者单位： Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands. Nutrition and Food Security Research Center, Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Clinical Studies and Nutritional Epidemiology, Nutrition Biomed Research Institute, Melbourne, Australia. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia. Department of Epidemiology, Schools for Oncology and Developmental Biology and Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands. Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. International Agency for Research on Cancer World Health Organization, Lyon, France. CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. School of Cancer Sciences, University of Birmingham, Birmingham, UK.

归属分类：膀胱肿瘤治疗及预后证据

DOI： 10.3389/fphar.2022.865988

关键词： Cystectomy/*methods Humans Organ Sparing Treatments/*methods Treatment Outcome Urinary Bladder Neoplasms/*surgery Bladder preservation High-grade non-muscle-invasive bladder cancer Meta-analysis Radical cystectomy PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

PURPOSE: We performed a meta-analysis to confirm the efficacy and safety of continuous saline bladder irrigation compared with intravesical chemotherapy after transurethral resection for the treatment of non-muscle invasive bladder cancer. METHODS: Randomized controlled trials of continuous saline bladder irrigation compared with intravesical chemotherapy were searched using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The data were evaluated and statistically analyzed using RevMan version 5.3.0. RESULTS: Four studies including 861 participants which compared continuous saline bladder irrigation with intravesical chemotherapy were considered. One-year recurrence-free survival [odds ratio (OR) = 0.76, 95% CI = 0.55-1.05, p = 0.09]; 2-year recurrence-free survival (OR = 0.94, 95% CI = 0.71-1.25, p = 0.68); the median period to first recurrence (OR = - 1.01, 95% CI = - 2.96 to 0.94, p = 0.31); the number of tumor progression (OR = 0.80, 95% CI = 0.54-1.17, p = 0.25); and the number of recurrence during follow-up (OR = 1.12, 95% CI = 0.84-1.50, p = 0.43) suggested that two methods of postoperative perfusion had no significant differences. In terms of safety, including macrohematuria, frequency of urination and bladder irritation symptoms, continuous saline bladder irrigation showed better tolerance than intravesical chemotherapy. CONCLUSION: Continuous saline bladder irrigation seems to provide a better balance between prevention of recurrence and local toxicities than intravesical chemotherapy after transurethral resection of bladder tumors.