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Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.

Publication ,  Journal Article
Abern, MR; Owusu, RA; Anderson, MR; Rampersaud, EN; Inman, BA
Published in: J Natl Compr Canc Netw
April 1, 2013

The role for a single dose of intravesical chemotherapy (IVC) after transurethral resection (TUR) remains unclear in patients with non-muscle-invasive bladder cancer (NMIBC). Several recent randomized clinical trials (RCTs) have evaluated its effect on recurrence, prompting this systematic review of RCTs comparing a single immediate postoperative dose of IVC versus placebo within 24 hours of TUR of NMIBC, and this meta-analysis using a random-effects model to predict the pooled relative risk (RR) of tumor recurrence. Subanalyses pooled studies by drug type and a meta-regression was performed to determine the effect of underlying patient risk factors on the efficacy of a single dose of IVC. A total of 3103 patients were randomized in the 18 RCTs that met inclusion criteria. The recurrence rate in patients receiving perioperative IVC and TUR was 37% versus 50% in the TUR-alone group. The pooled RR of recurrence for IVC and TUR was 0.67 (95% CI, 0.56-0.79), corresponding to a 13% absolute reduction and a number needed to treat of 7.2 patients to avoid 1 recurrence. The proportions of patients with tumor risk factors (T1, high-grade, multifocal, or recurrent) were not associated with IVC efficacy. A single dose of IVC administered within 24 hours of TUR of NMIBC was found to result in a reduction in tumor recurrence (RR, 0.67; 95% CI, 0.56-0.79). Patients with higher-risk tumor features seem to benefit at a similar rate.

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Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

April 1, 2013

Volume

11

Issue

4

Start / End Page

477 / 484

Location

United States

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Survival Analysis
  • Randomized Controlled Trials as Topic
  • Perioperative Care
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Humans
  • Drug Administration Schedule
  • Combined Modality Therapy
  • Chemotherapy, Adjuvant
 

Citation

APA
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Abern, M. R., Owusu, R. A., Anderson, M. R., Rampersaud, E. N., & Inman, B. A. (2013). Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. J Natl Compr Canc Netw, 11(4), 477–484. https://doi.org/10.6004/jnccn.2013.0060
Abern, Michael R., Richmond A. Owusu, Mark R. Anderson, Edward N. Rampersaud, and Brant A. Inman. “Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.J Natl Compr Canc Netw 11, no. 4 (April 1, 2013): 477–84. https://doi.org/10.6004/jnccn.2013.0060.
Abern MR, Owusu RA, Anderson MR, Rampersaud EN, Inman BA. Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. J Natl Compr Canc Netw. 2013 Apr 1;11(4):477–84.
Abern, Michael R., et al. “Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis.J Natl Compr Canc Netw, vol. 11, no. 4, Apr. 2013, pp. 477–84. Pubmed, doi:10.6004/jnccn.2013.0060.
Abern MR, Owusu RA, Anderson MR, Rampersaud EN, Inman BA. Perioperative intravesical chemotherapy in non-muscle-invasive bladder cancer: a systematic review and meta-analysis. J Natl Compr Canc Netw. 2013 Apr 1;11(4):477–484.

Published In

J Natl Compr Canc Netw

DOI

EISSN

1540-1413

Publication Date

April 1, 2013

Volume

11

Issue

4

Start / End Page

477 / 484

Location

United States

Related Subject Headings

  • Urinary Bladder Neoplasms
  • Survival Analysis
  • Randomized Controlled Trials as Topic
  • Perioperative Care
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Humans
  • Drug Administration Schedule
  • Combined Modality Therapy
  • Chemotherapy, Adjuvant