scholarly journals The efficacy and safety of thulium laser resection of bladder tumor versus standard transurethral resection in patients with non muscle-invasive bladder cancer: a systematic review and meta-analysis

2021 ◽  
Keyword(s):  
Bladder Cancer ◽  
Recurrence Rate ◽  
Bladder Tumor ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Thulium Laser ◽  
Muscle Invasive Bladder Cancer ◽  
Laser Resection ◽  
Significant Difference ◽  
Muscle Invasive

Purpose: This study was to analyze the efficacy and safety of thulium laser resection of bladder tumor (Tm-TURBT) versus TURBT for patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: Randomized controlled trial data were retrieved using the MEDLINE, Embase, Web of Science, and the Cochrane Library. We also searched Chinese databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang data and VIP data. Results: A total of sixteen articles including 1662 participants were enrolled into our meta-analysis. We found no significant difference in terms of operation time, urethral stricture, 1-year recurrence rate, overall 1-year recurrence rate and overall 3-year recurrence rate between the two groups. Less intraoperative blood loss and a lower incidence of obturator nerve reflex (ONR), bladder perforation and bladder irritation were identified in Tm-TURBT group than in TURBT group in our analysis. The analysis also demonstrated faster postoperative recovery in terms of the catheterization, bladder irrigation and hospitalization time in Tm-TURBT group. The subgroup analysis was conducted based on different postoperative chemotherapy (epirubicin and non-epirubicin) concerning recurrence rate whereas no significant difference was noted. Conclusion: Tm-TURBT is an efficient and safe treatment for NMIBC and it could be an alternative choice for TURBT. Given that some limitations are clearly identified, more large-scale and well-designed RCTs are needed to confirm our findings.

Comparison of Thulium Laser Resection of Bladder Tumors and Conventional Transurethral Resection of Bladder Tumors for Non-Muscle-Invasive Bladder Cancer

2021 ◽  
pp. 1-6
Author(s):  
Zheng Liu ◽  
Yucong Zhang ◽  
Guoliang Sun ◽  
Wei Ouyang ◽  
Shen Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Invasive Bladder Cancer ◽  
Perioperative Outcomes ◽  
Thulium Laser ◽  
Bladder Tumors ◽  
Muscle Invasive Bladder Cancer ◽  
Laser Resection ◽  
Baseline Characteristics ◽  
Muscle Invasive

<b><i>Introduction:</i></b> The thulium laser resection of bladder tumors (TmLRBT) was increasingly used in the treatment of non-muscle-invasive bladder cancer (NMIBC) recently, and here we report the relevant outcomes of our institution to evaluate its efficacy and safety. <b><i>Methods:</i></b> We retrospectively collected the data of NMIBC patients who underwent either TmLRBT or transurethral resection of bladder tumor (TURBT). The baseline characteristics and perioperative outcomes were compared in these 2 groups. <b><i>Results:</i></b> The TmLRBT had a higher rate of detrusor identification than TURBT (97.4 vs. 87.6%, <i>p</i> = 0.001). After screening, 134 patients who underwent TmLRBT and 152 patients who received TURBT were enrolled in the analysis, and their baseline characteristics were similar. During the TURBT, 24 (15.8%) obturator nerve reflexes and 9 (5.9%) bladder perforations occurred, while none happened during the TmLRBT. After surgery, TmLRBT patients had fewer postoperative gross hematuria (38.1 vs. 96.7%, <i>p</i> &#x3c; 0.001) and postoperative irrigation (27.6 vs. 92.7%, <i>p</i> &#x3c; 0.001), and its irrigation duration was significantly shorter (2.3 vs. 3.3 day, <i>p</i> &#x3c; 0.001). During the follow-up, no significant difference in the recurrence rate was detected (<i>p</i> = 0.315). <b><i>Conclusions:</i></b> TmLRBT is a safer technique than conventional TURBT in the treatment of NMIBC, and it could offer better specimens for pathologic assessment while the cancer control was not compromised.

scholarly journals Evaluating the efficacy and safety of intravesical chemotherapies for non-muscle invasive bladder cancer: a network meta-analysis

Oncotarget ◽  
2016 ◽  
Vol 7 (50) ◽  
pp. 82567-82579 ◽  
Author(s):  
Chuanjun Zhuo ◽  
Xubin Li ◽  
Hongqing Zhuang ◽  
Shunli Tian ◽  
Hailong Cui ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Meta Analysis ◽  
Invasive Bladder Cancer ◽  
Efficacy And Safety ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals Systematic Review and Meta-Analysis of Cisplatin Based Neoadjuvant Chemotherapy in Muscle Invasive Bladder Cancer

2021 ◽  
pp. 1-13
Author(s):  
Raed Benkhadra ◽  
Tarek Nayfeh ◽  
Sai Krishna Patibandla ◽  
Chelsea Peterson ◽  
Larry Prokop ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Meta Analysis ◽  
Nausea And Vomiting ◽  
Phase Iii ◽  
Invasive Bladder Cancer ◽  
Efficacy And Safety ◽  
Muscle Invasive Bladder Cancer ◽  
Increased Risk ◽  
Muscle Invasive

BACKGROUND: Cisplatin-based neoadjuvant chemotherapy is the standard of care for muscle invasive bladder cancer (MIBC). OBJECTIVE: To compare the efficacy and safety of the two most commonly used cisplatin-based regimens; gemcitabine, and cisplatin (GC) vs. accelerated (dose-dense: dd) or conventional methotrexate, vinblastine, adriamycin, and cisplatin (MVAC). METHODS: We searched MEDLINE, Embase, Scopus and other sources. Outcomes of interest included overall survival, downstaging to pT≤1, pathologic complete response (pCR), recurrence, and toxicity. Meta-analysis was conducted using the random-effects model. RESULTS: We identified 24 studies. Efficacy outcomes were comparable between MVAC and GC for MIBC. dd-MVAC was associated with favorable efficacy compared to GC in terms of downstaging (OR 1.45; 95%CI 1.15–1.82) and all-cause mortality at longest follow-up (OR 0.63; 95%CI 0.44–0.81). However, GC was associated with a better safety profile in terms of febrile neutropenia (OR 0.32; 95%CI 0.13–0.80), anemia (OR 0.32; 95%CI 0.18–0.54), nausea and vomiting (OR 0.27; 95%CI 0.12–0.65) compared to dd-MVAC. Compared to MVAC, patients receiving GC had an increased risk of developing grade 3–4 thrombocytopenia (OR 4.70; 95%CI 1.59–13.89) and a lower risk of nausea and vomiting (OR 0.05; 95%CI 0.01–0.31). Certainty in the estimates was very low for most outcomes. CONCLUSIONS: Efficacy and safety outcomes were comparable between MVAC and GC for MIBC. Including non-peer-reviewed studies showed higher efficacy with dd-MVAC. A phase III randomized trial comparing the two regimens is needed to guide clinical practice.

Methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) versus gemcitabine, and cisplatin (GC) as neoadjuvant chemotherapy in muscle-invasive bladder cancer, a systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16522-e16522
Author(s):  
Raed Benkhadra ◽  
Tarek Nayfeh ◽  
Naga Sai Krishna Patibandla ◽  
Chelsea Peterson ◽  
Larry Prokop ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Meta Analysis ◽  
Nausea And Vomiting ◽  
Phase Iii ◽  
Invasive Bladder Cancer ◽  
Efficacy And Safety ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

e16522 Background: Cisplatin-based neoadjuvant chemotherapy is the standard of care for muscle invasive bladder cancer (MIBC) in cisplatin-eligible patients. This systematic review and meta-analysis provide an updated efficacy and safety comparison between the two most commonly used cisplatin-based regimens; dose-dense (dd) or conventional MVAC versus GC. Methods: We searched different databases for studies comparing MVAC versus GC in the neoadjuvant setting. Outcomes of interest included overall survival, downstaging to pT≤1, pathologic complete response (pCR), recurrence, and toxicity. Meta-analysis was conducted using the random-effects model. Results: We identified 24 studies from inception to March 2020; among them 17 were peer reviewed and 7 were only reported as abstracts in national or international meetings, including a phase 3, randomized-controlled clinical trial. Among peer-reviewed published studies, efficacy outcomes such as OS, downstaging and pCR were comparable between conventional MVAC and GC for MIBC. If including non-peer-reviewed studies, dd-MVAC was associated with favorable efficacy compared to GC in terms of downstaging (OR 1.45; 95% CI 1.15–1.82), and OS at longest follow-up (OR 0.63; 95% CI 0.44–0.81). However, GC was associated with a better safety profile in terms of febrile neutropenia (OR 0.32; 95% CI 0.13–0.80), anemia (OR 0.32; 95% CI 0.18–0.54), nausea and vomiting (OR 0.27; 95% CI 0.12–0.65) compared to dd-MVAC. Compared to MVAC, patients receiving GC had an increased risk of developing grade 3–4 thrombocytopenia (OR 4.70; 95% CI 1.59–13.89) and a lower risk of nausea and vomiting (OR 0.05; 95% CI 0.01-0.31). Certainty in the estimates was very low for most outcomes. Conclusions: Among peer-reviewed published studies, efficacy and safety outcomes were comparable between conventional MVAC and GC for MIBC. However, If including non-peer-reviewed studies, this analysis showed higher efficacy with dd-MVAC. A phase III randomized trial comparing the two regimens is needed to guide clinical practice

scholarly journals The effect of holmium laser resection versus standard transurethral resection on non-muscle-invasive bladder cancer: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Changlong Li ◽  
Liang Gao ◽  
Jindong Zhang ◽  
Xiaokang Yang ◽  
Chuan Liu
Keyword(s):  
Bladder Cancer ◽  
Urethral Stricture ◽  
Transurethral Resection ◽  
Bladder Tumor ◽  
Obturator Nerve ◽  
Muscle Invasive Bladder Cancer ◽  
Laser Resection ◽  
Muscle Invasive ◽  
Time Of Operation

Abstract Purpose: To explore the advantages and limitations of holmium laser resection of the bladder tumor (HOLRBT) versus standard transurethral resection of the bladder tumor (TURBT) in the treatment of non-muscle-invasive bladder cancer (NMIBC). Methods: The eligible studies were selected from the following databases: PubMed, Cochrane Library and Embase. Studies comparing HOLRBT and TURBT for patients with NMIBC were included. The outcomes of interest were time of operation, catheterization, and hospitalization, rates of recurrence and perioperative complications, including obturator nerve reflex, bladder perforation, bladder irritation and urethral stricture. Results of all data were compared and analyzed by Review Manager 5.3. Results: A total of 9 comparative studies were finally included for analysis. Pooled data demonstrated that HOLRBT could significantly reduce the time in catheterization and hospitalization, the rates of recurrence in 2 years of follow-up, obturator nerve reflex, bladder perforation, bladder irritation compared with those in TURBT, respectively. However, no significant difference could be found between HOLRBT and TURBT in the time of operation, rate of recurrence at 1-year follow-up and urethral stricture. Conclusions: The results of our research showed that HOLRBT would be a better choice than TURBT for patients with NMIBC.

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