Wei Liu1, Jinhui Tian2, Su Zhang1, Enguang Yang1, Haixiang Shen3, Fudong Li4, Kailing Li5, Tao Zhang1, Hanzhang Wang6, Robert S Svatek6, Ronald Rodriguez6, Zhiping Wang7. 1. Key Laboratory of Gansu Province for Urological Diseases, Institute of Urology, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, Lanzhou, Gansu Province, China. 2. Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province, Evidence-based Medicine Center of Lanzhou University, Lanzhou, China. 3. Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China. 4. Department of Urology, Lanzhou General Hospital of People's Liberation Army, Lanzhou, China. 5. Department of Urology, First Hospital of Lanzhou University, Lanzhou, China. 6. Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA. 7. Key Laboratory of Gansu Province for Urological Diseases, Institute of Urology, Lanzhou University Second Hospital, Gansu Nephro-Urological Clinical Center, Lanzhou, Gansu Province, China - wangzplzu@163.com.
Abstract
INTRODUCTION: To give a comprehensive depiction of the utilization status of neoadjuvant chemotherapy (NAC) in muscle invasive bladder cancer (MIBC) worldwide. EVIDENCE ACQUISITION: Potential relevant research papers of Pubmed, Embase, Web of Science, and the Cochrane Library were reviewed to identify eligible studies. Primary outcomes of this meta-analysis were utilization rate of NAC and its utility distribution in different genders, races, ages, countries and temporal trends. The utilization rates of NAC were calculated as 'Proportion (s)' with 95% confidence intervals (CIs) and pooled estimates were calculated by using a random-effect model. EVIDENCE SYNTHESIS: A total of thirteen studies and 35,738 patients were included. The total proportion of NAC applied in MIBC populations prior to radical cystectomy (RC) was 17.2% (95% CI: 12.5-21.9%, I2=99.7%). The comparative analyses showed there were no significant differences existing in different genders or races on NAC utilization rates. In terms of age distribution, <60 age group conferred higher utilization rate of NAC than the older (OR=1.919, 95% CI: 1.671-2.202, P=0.0001). As for regional distribution, our meta-analysis showed that Japan (Proportion: 44.0%, 95% CI: 6.5-81.5%, I2=99.6%) and Sweden (37.9%, 95% CI: 34.9-40.8%) were the top two leading countries which contributed to the most frequent application of NAC. In respect of pathologic responses after NAC, complete, partial and down-staged pathologic responses were achieved in 16.6% (95% CI: 7.4-25.9%, I2=89.7%), 14.6% (95% CI: 0.8-28.5%, I2=89.7%) and 45.0% (95% CI: 17.8-72.2%, I2=98.8%) patients, respectively. CONCLUSIONS: The present study shows the low utilization rate of NAC in MIBC patients. Standardization of the treatment modality of MIBC and promotion of guidelines might be necessary to expedite the adoption of NAC in near future.
INTRODUCTION: To give a comprehensive depiction of the utilization status of neoadjuvant chemotherapy (NAC) in muscle invasive bladder cancer (MIBC) worldwide. EVIDENCE ACQUISITION: Potential relevant research papers of Pubmed, Embase, Web of Science, and the Cochrane Library were reviewed to identify eligible studies. Primary outcomes of this meta-analysis were utilization rate of NAC and its utility distribution in different genders, races, ages, countries and temporal trends. The utilization rates of NAC were calculated as 'Proportion (s)' with 95% confidence intervals (CIs) and pooled estimates were calculated by using a random-effect model. EVIDENCE SYNTHESIS: A total of thirteen studies and 35,738 patients were included. The total proportion of NAC applied in MIBC populations prior to radical cystectomy (RC) was 17.2% (95% CI: 12.5-21.9%, I2=99.7%). The comparative analyses showed there were no significant differences existing in different genders or races on NAC utilization rates. In terms of age distribution, <60 age group conferred higher utilization rate of NAC than the older (OR=1.919, 95% CI: 1.671-2.202, P=0.0001). As for regional distribution, our meta-analysis showed that Japan (Proportion: 44.0%, 95% CI: 6.5-81.5%, I2=99.6%) and Sweden (37.9%, 95% CI: 34.9-40.8%) were the top two leading countries which contributed to the most frequent application of NAC. In respect of pathologic responses after NAC, complete, partial and down-staged pathologic responses were achieved in 16.6% (95% CI: 7.4-25.9%, I2=89.7%), 14.6% (95% CI: 0.8-28.5%, I2=89.7%) and 45.0% (95% CI: 17.8-72.2%, I2=98.8%) patients, respectively. CONCLUSIONS: The present study shows the low utilization rate of NAC in MIBCpatients. Standardization of the treatment modality of MIBC and promotion of guidelines might be necessary to expedite the adoption of NAC in near future.
Authors: Se Young Choi; Moon Soo Ha; Byung Hoon Chi; Jin Wook Kim; In Ho Chang; Tae-Hyoung Kim; Soon Chul Myung; Myoungsuk Kim; Kyung-Eun Lee; Yuwon Kim; Hyun-Ki Woo; Dae-Sung Kyoung; Hasung Kim Journal: J Cancer Res Clin Oncol Date: 2022-01-21 Impact factor: 4.322
Authors: Katarzyna Gronostaj; Anna Katarzyna Czech; Jakub Fronczek; Tomasz Wiatr; Mikołaj Przydacz; Przemysław Dudek; Łukasz Curyło; Wojciech Szczeklik; Piotr Chłosta Journal: Cent European J Urol Date: 2020-02-27