Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis
Abstract Objective Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (MIBC). As a bladder-preservation option recommended in guidelines, trimodal therapy (TMT) has become increasingly popular in recent years. However, it is still uncertain whether TMT can prov...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-08-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-03161-z |
| _version_ | 1797559259569848320 |
|---|---|
| author | Xiaozhe Su Caitao Dong Wenbiao Liao Wentao Liu |
| author_facet | Xiaozhe Su Caitao Dong Wenbiao Liao Wentao Liu |
| author_sort | Xiaozhe Su |
| collection | DOAJ |
| description | Abstract Objective Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (MIBC). As a bladder-preservation option recommended in guidelines, trimodal therapy (TMT) has become increasingly popular in recent years. However, it is still uncertain whether TMT can provide comparable oncologic outcomes to RC. Therefore, it is imperative to evaluate whether TMT yields comparable outcomes to RC. Methods We conducted a systematic search of Web of Science, MEDLINE, the Cochrane Library, and EMBASE databases up to June 2023 to identify studies that met our inclusion criteria. The primary outcome measures evaluated in this study were overall survival (OS) and cancer-specific survival (CSS). The study quality was evaluated independently by two authors, and data were extracted accordingly. Results After excluding duplicates and ineligible articles, our meta-analysis included seven studies involving 3,489 and 13,877 patients in the TMT and RC groups, respectively. Short-term overall survival rates were comparable between the groups, but beyond 5 and > 10-years, the RC group had significantly higher overall survival rates compared to the TMT group. In terms of cancer-specific survival, there was no significant difference between the groups at 1-year follow-up, but from the second year onwards, including the 5-year and > 10-year nodes, the RC group had significantly better outcomes compared to the TMT group. Conclusion The treatment effect of RC is better than that of TMT. Unless the patient can’t tolerate RC or has a strong desire to preserve the bladder, RC should be chosen over TMT in treatment, and patients undergoing TMT should be closely followed up. |
| first_indexed | 2024-03-10T17:42:53Z |
| format | Article |
| id | doaj.art-7b1fbf3a97f24fbeaf1c07d190210a16 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-03-10T17:42:53Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-7b1fbf3a97f24fbeaf1c07d190210a162023-11-20T09:37:20ZengBMCWorld Journal of Surgical Oncology1477-78192023-08-012111910.1186/s12957-023-03161-zOncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysisXiaozhe Su0Caitao Dong1Wenbiao Liao2Wentao Liu3Department of Urology, The Second Xiangya Hospital of Central South UniversityDepartment of Urology, Renmin Hospital of Wuhan UniversityDepartment of Urology, Renmin Hospital of Wuhan UniversityDepartment of Urology, The Second Xiangya Hospital of Central South UniversityAbstract Objective Radical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder cancer (MIBC). As a bladder-preservation option recommended in guidelines, trimodal therapy (TMT) has become increasingly popular in recent years. However, it is still uncertain whether TMT can provide comparable oncologic outcomes to RC. Therefore, it is imperative to evaluate whether TMT yields comparable outcomes to RC. Methods We conducted a systematic search of Web of Science, MEDLINE, the Cochrane Library, and EMBASE databases up to June 2023 to identify studies that met our inclusion criteria. The primary outcome measures evaluated in this study were overall survival (OS) and cancer-specific survival (CSS). The study quality was evaluated independently by two authors, and data were extracted accordingly. Results After excluding duplicates and ineligible articles, our meta-analysis included seven studies involving 3,489 and 13,877 patients in the TMT and RC groups, respectively. Short-term overall survival rates were comparable between the groups, but beyond 5 and > 10-years, the RC group had significantly higher overall survival rates compared to the TMT group. In terms of cancer-specific survival, there was no significant difference between the groups at 1-year follow-up, but from the second year onwards, including the 5-year and > 10-year nodes, the RC group had significantly better outcomes compared to the TMT group. Conclusion The treatment effect of RC is better than that of TMT. Unless the patient can’t tolerate RC or has a strong desire to preserve the bladder, RC should be chosen over TMT in treatment, and patients undergoing TMT should be closely followed up.https://doi.org/10.1186/s12957-023-03161-zMuscle-invasive bladder cancerTrimodal therapyRadical cystectomy, Meta-analysis |
| spellingShingle | Xiaozhe Su Caitao Dong Wenbiao Liao Wentao Liu Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis World Journal of Surgical Oncology Muscle-invasive bladder cancer Trimodal therapy Radical cystectomy, Meta-analysis |
| title | Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis |
| title_full | Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis |
| title_fullStr | Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis |
| title_full_unstemmed | Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis |
| title_short | Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis |
| title_sort | oncological effectiveness of bladder preserving trimodal therapy versus radical cystectomy for the treatment of muscle invasive bladder cancer a system review and meta analysis |
| topic | Muscle-invasive bladder cancer Trimodal therapy Radical cystectomy, Meta-analysis |
| url | https://doi.org/10.1186/s12957-023-03161-z |
| work_keys_str_mv | AT xiaozhesu oncologicaleffectivenessofbladderpreservingtrimodaltherapyversusradicalcystectomyforthetreatmentofmuscleinvasivebladdercancerasystemreviewandmetaanalysis AT caitaodong oncologicaleffectivenessofbladderpreservingtrimodaltherapyversusradicalcystectomyforthetreatmentofmuscleinvasivebladdercancerasystemreviewandmetaanalysis AT wenbiaoliao oncologicaleffectivenessofbladderpreservingtrimodaltherapyversusradicalcystectomyforthetreatmentofmuscleinvasivebladdercancerasystemreviewandmetaanalysis AT wentaoliu oncologicaleffectivenessofbladderpreservingtrimodaltherapyversusradicalcystectomyforthetreatmentofmuscleinvasivebladdercancerasystemreviewandmetaanalysis |