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肌肉侵入性膀癌的三种疗法与激进囊切除术:系统性审查和元分析

Khi Yung Fong¹, Ee Jean Lim², Hung Chew Wong³

¹Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Ministry of Health Holdings, Singapore.

Urologic oncology

|February 22, 2025

概括

激进囊切除术 (RC) 提供了更好的整体存活率 (OS) 和癌症特异性存活率 (CSS),而不是肌肉侵入性膀癌 (MIBC) 的三模式疗法 (TMT). RC仍然是标准的护理,尽管TMT是选择患者的可行选择.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.
手术瘤学手术瘤学

背景情况:

激进囊切除术 (RC) 是肌肉侵入性膀癌 (MIBC) 的既定标准.
三种疗法 (TMT) 是一种新兴的替代方案,旨在保护膀并改善存活率.

研究的目的:

为了比较RC与TMT对MIBC的疗效.
评估这些治疗方式之间的整体生存率 (OS) 和癌症特异性生存率 (CSS).

主要方法:

对随机或匹配研究进行系统的文献搜索,比较MIBC的RC和TMT.
使用考克斯模型对个体患者数据 (IPD) 的元分析,以确定危险比率 (HRs) 和95%置信区间 (CI).

主要成果:

分析了11项研究 (主要是cT2-T4,节点阴性,非转移性MIBC).
与RC相比,TMT显示了较低的OS (HR=1.14) 和CSS (HR=1.09) 与RC相比.
估计的10年运行期:TMT为18%,RC为22%;10年的CSS:TMT为29%,RC为29%.

结论:

在没有大型试验的情况下,RC可能会为MIBC提供比TMT更好的生存益处.
对于非转移性MIBC,RC应该仍然是治疗的标准.
对于精心挑选和知情的患者来说,TMT是一个有效的替代方案.

关键词:

膀癌是一种癌症.进行元分析分析.进行激进的囊切除术.系统性审查系统性审查三种治疗方式的疗法.

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