Comparison of single-course versus multiple course prophylactic intravesical instillation chemotherapy for bladder tumor recurrence after radical nephroureterectomy for upper tract urothelial carcinoma: a systematic review and meta-analysis
10.3760/cma.j.issn.0254-9026.2023.10.021
- VernacularTitle:上尿路尿路上皮癌根治术后预防性膀胱灌注化疗：单次与多次膀胱灌注化疗的系统综述和Meta分析
- Author:
Pengjie WU
1
;
Dong WEI
;
Hong MA
;
Bin JIN
;
Yaqun ZHANG
;
Shuangyi ZHAO
;
Xin CHU
;
Jianye WU
;
Ben WAN
;
Jianye WANG
Author Information
1. 北京医院泌尿外科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Urinary bladder neoplasms;
Chemotherapy, cancer, regional perthision;
Upper tract urothelial carcinoma;
Meta-analysis
- From:
Chinese Journal of Geriatrics
2023;42(10):1254-1258
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine whether multiple-course prophylactic intravesical instillation chemotherapy is superior to single-course chemotherapy in preventing bladder tumor recurrence after radical nephroureterectomy(RNU)for primary upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed, Wanfang Data and China National Knowledge Infrastructure and all publications before March 2021 about clinical trials comparing the effects of single-course and multiple-course prophylactic intravesical instillation chemotherapy after RNU for UTUC were retrieved.Analysis was performed using Stata/SE 12.0.Results:Seven trials included a total of 998 patients, with 473 participants receiving multiple-course and 525 receiving single-course intravesical instillation chemotherapy.Bladder cancer recurrence occurred in 69 out of 473 patients(14.6%)with multiple-course chemotherapy and in 123 out of 525 patients(23.4%)with single-course chemotherapy.The absolute risk reduction was 8.8% and the relative risk reduction was 37.6%.Compared with a single-course instillation, the pooled OR of bladder cancer recurrence was 0.55(95% CI: 0.40-0.76, P<0.001)for multiple-course instillations.No serious adverse events were reported. Conclusions:Compared with single-course instillation chemotherapy, multiple-course prophylactic intravesical instillation chemotherapy significantly decreases the risk of bladder cancer recurrence in primary UTUC patients treated with RNU, indicating multiple intravesical instillation chemotherapy is superior to single instillation chemotherapy.
