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Titel: Adjuvant Chemotherapy for Muscle-invasive Bladder Cancer : A Systematic Review and Meta-analysis of Individual Participant Data from Randomised Controlled Trials
VerfasserIn: Burdett, Sarah
Fisher, David J.
Vale, Claire L.
Sternberg, Cora N.
Clarke, Noel W.
Parmar, Mahesh K.B.
Bono, Aldo V.
Cognetti, Francesco
Collette, Laurence
Cote, Richard J.
Goebell, Peter J.
Groshen, Susan
Lehmann, Jan
Rolevich, Alexander I.
Sonntag, Roland W.
Stöckle, Michael
Studer, Urs E.
Torti, Frank M.
Zhegalik, Alexander G.
Tierney, Jayne F.
Sprache: Englisch
Titel: European Urology
Bandnummer: 81 (2022)
Heft: 1
Seiten: 50-61
Verlag/Plattform: Elsevier
Erscheinungsjahr: 2021
Freie Schlagwörter: Bladder cancer
Chemotherapy
Individual participant data
Meta-analysis
Systematic review
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Context Our prior systematic review and meta-analysis of individual participant data (IPD) suggesting a benefit of adjuvant chemotherapy for muscle-invasive bladder cancer was limited by the number and size of included randomised trials. We have updated results to include additional trials, providing the most up-to-date and reliable evidence of the effects of this treatment. Objective To investigate the role of adjuvant cisplatin-based chemotherapy in the treatment of muscle-invasive bladder cancer. Evidence acquisition Published and unpublished trials were sought via searches of bibliographic databases, trials registers, conference proceedings, and hand searching. Updated IPD were centrally collected, checked, and analysed. Results from individual randomised controlled trials (RCTs) were combined using a two-stage fixed-effect model. Prespecified analyses explored any variation in effect by trial and participant characteristics. Evidence synthesis Analyses of ten RCTs (1183 participants) demonstrated a benefit of cisplatin-based adjuvant chemotherapy on overall survival (hazard ratio [HR] = 0.82, 95% confidence interval [CI] = 0.70–0.96, p = 0.02). This represents an absolute improvement in survival of 6% at 5 yr, from 50% to 56%, and a 9% absolute benefit when adjusted for age, sex, pT stage, and pN category (HR = 0.77, 95% CI = 0.65–0.92, p = 0.004). There was no clear evidence that the effect varied by trial or participant characteristics. Adjuvant chemotherapy was also shown to improve recurrence-free survival (HR = 0.71, 95% CI = 0.60–0.83, p < 0.001), locoregional recurrence-free survival (HR = 0.68, 95% CI = 0.55–0.85, p < 0.001), and metastasis-free survival (HR = 0.79, 95% CI = 0.65–0.95, p = 0.01), with absolute benefits of 11%, 11%, and 8%, respectively. Conclusions This systematic review and meta-analysis demonstrates that cisplatin-based adjuvant chemotherapy is a valid option for improving outcomes for muscle-invasive bladder cancer. Patient summary We looked at the effect of cisplatin-based chemotherapy on outcomes in participants with muscle-invasive bladder cancer. We gathered this information from eligible randomised controlled trials. We demonstrated that cisplatin-based chemotherapy is a valid option for improving outcomes of muscle-invasive bladder cancer.
DOI der Erstveröffentlichung: 10.1016/j.eururo.2021.09.028
URL der Erstveröffentlichung: https://www.sciencedirect.com/science/article/pii/S0302283821020583
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-376931
hdl:20.500.11880/34098
http://dx.doi.org/10.22028/D291-37693
ISSN: 0302-2838
Datum des Eintrags: 25-Okt-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary material
In Beziehung stehendes Objekt: https://ars.els-cdn.com/content/image/1-s2.0-S0302283821020583-mmc1.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Urologie und Kinderurologie
Professur: M - Prof. Dr. Michael Stöckle
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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