Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis
PurposeThe purpose of this study was to summarize the existing evidence and develop a comprehensive systematic review of the impact of androgen suppression therapy (AST) on the incidence or clinical outcomes of bladder cancer.MethodsWe systematically searched the PubMed and Embase databases from inc...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-12-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.784627/full |
| _version_ | 1819180446831869952 |
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| author | Peng Xiang Peng Xiang Zhen Du Yongxiu Hao Di Guan Dan Liu Wei Yan Mingdong Wang Yutong Liu Hao Ping Hao Ping |
| author_facet | Peng Xiang Peng Xiang Zhen Du Yongxiu Hao Di Guan Dan Liu Wei Yan Mingdong Wang Yutong Liu Hao Ping Hao Ping |
| author_sort | Peng Xiang |
| collection | DOAJ |
| description | PurposeThe purpose of this study was to summarize the existing evidence and develop a comprehensive systematic review of the impact of androgen suppression therapy (AST) on the incidence or clinical outcomes of bladder cancer.MethodsWe systematically searched the PubMed and Embase databases from inception to June 20, 2021 to identify all observational studies examining the incidence or clinical outcomes of bladder cancer in patients who received AST. AST is defined as the use of 5-alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT).ResultsA total of 18 observational studies were included. Our results showed that AST was not significantly associated with a reduced risk of BCa incidence (OR: 0.92, 95% CI: 0.68–1.24) compared with the lack of AST. The subgroup analysis revealed that finasteride use was significantly associated with a reduction in the risk of BCa incidence (OR: 0.75, 95% CI: 0.64–0.88). Recurrence-free survival (RFS) was improved among AST users compared with nonusers (HR: 0.68, 95% CI: 0.48–0.95), while no significant difference between AST users versus nonusers was identified for cancer-specific survival (CSS), overall survival (OS) or progression-free survival (PFS).ConclusionCurrent evidence indicates that therapy with finasteride may represent a potential strategy aimed at reducing BCa incidence. Moreover, AST has a beneficial effect on the recurrence of bladder cancer. Further well-designed randomized trials or cohort studies with better characterized study populations are needed to validate our preliminary findings.Systematic Review RegistrationInternational Prospective Register of Systematic Reviews database [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42021261685. |
| first_indexed | 2024-12-22T22:14:29Z |
| format | Article |
| id | doaj.art-c3446007ba954e0b85dd2da865a6c6a1 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-22T22:14:29Z |
| publishDate | 2021-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c3446007ba954e0b85dd2da865a6c6a12022-12-21T18:10:49ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-12-011110.3389/fonc.2021.784627784627Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-AnalysisPeng Xiang0Peng Xiang1Zhen Du2Yongxiu Hao3Di Guan4Dan Liu5Wei Yan6Mingdong Wang7Yutong Liu8Hao Ping9Hao Ping10Department of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaBeijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing Tongren Hospital, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaDepartment of Urology, Beijing Tongren Hospital, Capital Medical University, Beijing, ChinaBeijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University & Capital Medical University, Beijing Tongren Hospital, Beijing, ChinaPurposeThe purpose of this study was to summarize the existing evidence and develop a comprehensive systematic review of the impact of androgen suppression therapy (AST) on the incidence or clinical outcomes of bladder cancer.MethodsWe systematically searched the PubMed and Embase databases from inception to June 20, 2021 to identify all observational studies examining the incidence or clinical outcomes of bladder cancer in patients who received AST. AST is defined as the use of 5-alpha reductase inhibitors (5-ARIs) or androgen deprivation therapy (ADT).ResultsA total of 18 observational studies were included. Our results showed that AST was not significantly associated with a reduced risk of BCa incidence (OR: 0.92, 95% CI: 0.68–1.24) compared with the lack of AST. The subgroup analysis revealed that finasteride use was significantly associated with a reduction in the risk of BCa incidence (OR: 0.75, 95% CI: 0.64–0.88). Recurrence-free survival (RFS) was improved among AST users compared with nonusers (HR: 0.68, 95% CI: 0.48–0.95), while no significant difference between AST users versus nonusers was identified for cancer-specific survival (CSS), overall survival (OS) or progression-free survival (PFS).ConclusionCurrent evidence indicates that therapy with finasteride may represent a potential strategy aimed at reducing BCa incidence. Moreover, AST has a beneficial effect on the recurrence of bladder cancer. Further well-designed randomized trials or cohort studies with better characterized study populations are needed to validate our preliminary findings.Systematic Review RegistrationInternational Prospective Register of Systematic Reviews database [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42021261685.https://www.frontiersin.org/articles/10.3389/fonc.2021.784627/fullandrogen suppression therapybladder cancerincidencerecurrencemeta-analysis |
| spellingShingle | Peng Xiang Peng Xiang Zhen Du Yongxiu Hao Di Guan Dan Liu Wei Yan Mingdong Wang Yutong Liu Hao Ping Hao Ping Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis Frontiers in Oncology androgen suppression therapy bladder cancer incidence recurrence meta-analysis |
| title | Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis |
| title_full | Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis |
| title_short | Impact of Androgen Suppression Therapy on the Risk and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis |
| title_sort | impact of androgen suppression therapy on the risk and prognosis of bladder cancer a systematic review and meta analysis |
| topic | androgen suppression therapy bladder cancer incidence recurrence meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.784627/full |
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