评估新辅助膀胱内丝裂霉素C治疗naïve非肌肉浸润性膀胱癌的临床疗效：一项系统回顾和荟萃分析。

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer Pub Date : 2025-03-17 DOI:10.1016/j.currproblcancer.2025.101198

Anuja Thakur , Lalit Kumar , Sakshi Agarwal , Rachana Tripathy , Yashasvi Singh , Sameer Trivedi , Ujwal Kumar

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引用次数: 0

摘要

背景和目的：Naïve非肌肉浸润性膀胱癌（NMIBC）通常采用经尿道切除术（TURBT）治疗，但复发和进展仍然是人们关注的问题。这项荟萃分析是我们首次就这一主题进行的荟萃分析，比较了新辅助丝裂霉素C （MMC）和对照组（单独使用TURBT）治疗的患者的复发率和进展率。方法：采用结构化文献评价法对相关文章进行识别和评价。检索的数据库包括PubMed、Medline、Scopus和Science Direct。重复的出版物、书籍章节、会议论文、百科全书、病例报告、杂志文章、演讲、论文、协议、系统评价和元分析被排除在外。使用I2评估异质性。主要发现和局限性：荟萃分析评估了复发率、进展率和不良事件。未观察到异质性（I2= 0%）。合并奇数比（OR）为2.554 (95% CI: 1.637 ~ 3.986)，提示MMC组复发率显著降低（P < 0.001）。对于进展率，总的合并OR为1.508 (95% CI: 0.832-2.734)，表明MMC组表现出较低的进展率。但差异无统计学意义（P = 0.176）。不良事件各不相同，MMC组血尿病例较少（8.4%对34%），但膀胱刺激性症状较多。结论和临床意义：荟萃分析表明，与对照组相比，新辅助MMC组的复发率和进展率较低。两组都经历了相当范围的不良事件，这表明两种治疗方法具有相似的安全性。需要更大规模和更多的随机对照试验（RCT）来证实MMC在NIMBC治疗中的有效性，并确定其在临床实践中的作用。

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Assessing the clinical efficacy of neoadjuvant intravesical Mitomycin C in naïve non-muscle invasive urinary bladder cancer: A systematic review and meta-analysis

Background and Objective

Naïve non-muscle invasive bladder cancer (NMIBC) is commonly treated with transurethral resection (TURBT), but recurrence and progression remain concerns.

This meta-analysis, the first we have conducted on this topic, compared recurrence and progression rates between patients treated with neoadjuvant Mitomycin C (MMC) and the control group (TURBT alone).

Methods

Relevant articles were identified and appraised through a structured literature assessment. Databases searched included PubMed, Medline, Scopus, and Science Direct. Duplicate publications, book sections, conference papers, encyclopedias, case reports, magazine articles, presentations, theses, protocols, systematic reviews, and meta-analyses were excluded. Heterogeneity was assessed using the I².

Key findings and limitations

The meta-analysis evaluated recurrence rates, progression rates, and adverse events. No heterogeneity was observed (I²=0 %). The pooled odd ratio (OR) for recurrence was 2.554 (95 % CI: 1.637-3.986), indicating a significant decrease in recurrence for the MMC group (P < 0.001). For progression rates, the overall pooled OR was 1.508 (95 % CI: 0.832-2.734), suggesting that the MMC group showed a lower progression rate. However, this difference was not statistically significant (P = 0.176).Adverse events varied, with the MMC group showing fewer cases of hematuria (8.4 % vs. 34 %) but more irritative bladder symptoms.

Conclusions and Clinical Implications

The meta-analysis suggests lower recurrence and progression rates in the neoadjuvant MMC group compared to the control group. Both groups experienced a comparable range of adverse events, suggesting that both treatment approaches exhibit a similar safety profile. Larger and more randomized controlled trials (RCT) are needed to confirm MMC's effectiveness in NIMBC treatment and establish its role in clinical practice.

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来源期刊

Current Problems in Cancer 医学-肿瘤学

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

15 days

期刊介绍： Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.