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A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer

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A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer. / Yanagisawa, Takafumi; Quhal, Fahad; Kawada, Tatsushi; Mostafaei, Hadi; Sari Motlagh, Reza; Laukthina, Ekaterina; Rajwa, Pawel; von Deimling, Markus; Bianchi, Alberto; Pallauf, Maximilian; Majdoub, Muhammad; Pradere, Benjamin; Moschini, Marco; Karakiewicz, Pierre I; Teoh, Jeremy Yuen-Chun; Miki, Jun; Kimura, Takahiro; Shariat, Shahrokh F.

in: EUR UROL FOCUS, Jahrgang 9, Nr. 3, 05.2023, S. 463-479.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung

Harvard

Yanagisawa, T, Quhal, F, Kawada, T, Mostafaei, H, Sari Motlagh, R, Laukthina, E, Rajwa, P, von Deimling, M, Bianchi, A, Pallauf, M, Majdoub, M, Pradere, B, Moschini, M, Karakiewicz, PI, Teoh, JY-C, Miki, J, Kimura, T & Shariat, SF 2023, 'A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer', EUR UROL FOCUS, Jg. 9, Nr. 3, S. 463-479. https://doi.org/10.1016/j.euf.2022.12.003

APA

Yanagisawa, T., Quhal, F., Kawada, T., Mostafaei, H., Sari Motlagh, R., Laukthina, E., Rajwa, P., von Deimling, M., Bianchi, A., Pallauf, M., Majdoub, M., Pradere, B., Moschini, M., Karakiewicz, P. I., Teoh, J. Y-C., Miki, J., Kimura, T., & Shariat, S. F. (2023). A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer. EUR UROL FOCUS, 9(3), 463-479. https://doi.org/10.1016/j.euf.2022.12.003

Vancouver

Yanagisawa T, Quhal F, Kawada T, Mostafaei H, Sari Motlagh R, Laukthina E et al. A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer. EUR UROL FOCUS. 2023 Mai;9(3):463-479. https://doi.org/10.1016/j.euf.2022.12.003

Bibtex

@article{bc8d609638df4195b48304bdc217504c,
title = "A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer",
abstract = "ContextThe ablative effect of intravesical therapy is known for decades. However, the clinical feasibility and efficacy of chemoablation for non–muscle-invasive bladder cancer (NMIBC) have not become accepted.ObjectiveTo assess the treatment outcomes of chemoablation for NMIBC and to compare its safety with that of the standard treatment, transurethral resection of bladder tumors (TURBT) followed by intravesical therapy.Evidence acquisitionMultiple databases were queried in July 2022 for studies investigating the complete response (CR) rates and adverse events in NMIBC patients treated with chemoablation using mitomycin C (MMC), gemcitabine, epirubicin, or bacillus Calmette-Gu{\'e}rin.Evidence synthesisOverall, 23 studies comprising 1199 patients were eligible for this meta-analysis. Among these studies, 20 assessed the efficacy of chemoablation and three compared the treatment outcomes of MMC chemoablation versus standard treatment. Among patients treated with weekly administration of any agent, the pooled CR rates at initial assessment were 50.9% (95% confidence interval [CI]: 45.9–55.9) for the marker lesion and 47.5% (95% CI: 36.5–58.7) for well-selected NMIBC (ie, small tumors and/or a small number of tumors). Novel regimens for chemoablation such as MMC-gel (70.6%, 95% CI: 60.1–79.3) and an intensive MMC regimen (64.7%, 95% CI: 56.2–72.3) provided better CR rates in well-selected NMIBC patients. Comparable CR rates were noted irrespective of tumor multiplicity, whereas tumor size <5 mm was associated with a higher CR rate than tumor size ≥5 mm (odds ratio: 0.36, 95% CI: 0.17–0.79). The novel intensive MMC regimen resulted in lower rates of dysuria and urinary frequency than standard treatment.ConclusionsDespite the lack of long-term outcomes, chemoablation appears to be a promising treatment option for well-selected NMIBC patients and can potentially help avoid unnecessary TURBT, specifically in some elderly patients with intermediate-risk NMIBC. Further well-designed studies with larger cohorts are necessary to address the differential tolerability and long-term anticancer efficacy of this resurging approach.",
author = "Takafumi Yanagisawa and Fahad Quhal and Tatsushi Kawada and Hadi Mostafaei and {Sari Motlagh}, Reza and Ekaterina Laukthina and Pawel Rajwa and {von Deimling}, Markus and Alberto Bianchi and Maximilian Pallauf and Muhammad Majdoub and Benjamin Pradere and Marco Moschini and Karakiewicz, {Pierre I} and Teoh, {Jeremy Yuen-Chun} and Jun Miki and Takahiro Kimura and Shariat, {Shahrokh F}",
year = "2023",
month = may,
doi = "10.1016/j.euf.2022.12.003",
language = "English",
volume = "9",
pages = "463--479",
journal = "EUR UROL FOCUS",
issn = "2405-4569",
publisher = "Elsevier BV",
number = "3",

}

RIS

TY - JOUR

T1 - A Systematic Review and Meta-analysis of Chemoablation for Non-muscle-invasive Bladder Cancer

AU - Yanagisawa, Takafumi

AU - Quhal, Fahad

AU - Kawada, Tatsushi

AU - Mostafaei, Hadi

AU - Sari Motlagh, Reza

AU - Laukthina, Ekaterina

AU - Rajwa, Pawel

AU - von Deimling, Markus

AU - Bianchi, Alberto

AU - Pallauf, Maximilian

AU - Majdoub, Muhammad

AU - Pradere, Benjamin

AU - Moschini, Marco

AU - Karakiewicz, Pierre I

AU - Teoh, Jeremy Yuen-Chun

AU - Miki, Jun

AU - Kimura, Takahiro

AU - Shariat, Shahrokh F

PY - 2023/5

Y1 - 2023/5

N2 - ContextThe ablative effect of intravesical therapy is known for decades. However, the clinical feasibility and efficacy of chemoablation for non–muscle-invasive bladder cancer (NMIBC) have not become accepted.ObjectiveTo assess the treatment outcomes of chemoablation for NMIBC and to compare its safety with that of the standard treatment, transurethral resection of bladder tumors (TURBT) followed by intravesical therapy.Evidence acquisitionMultiple databases were queried in July 2022 for studies investigating the complete response (CR) rates and adverse events in NMIBC patients treated with chemoablation using mitomycin C (MMC), gemcitabine, epirubicin, or bacillus Calmette-Guérin.Evidence synthesisOverall, 23 studies comprising 1199 patients were eligible for this meta-analysis. Among these studies, 20 assessed the efficacy of chemoablation and three compared the treatment outcomes of MMC chemoablation versus standard treatment. Among patients treated with weekly administration of any agent, the pooled CR rates at initial assessment were 50.9% (95% confidence interval [CI]: 45.9–55.9) for the marker lesion and 47.5% (95% CI: 36.5–58.7) for well-selected NMIBC (ie, small tumors and/or a small number of tumors). Novel regimens for chemoablation such as MMC-gel (70.6%, 95% CI: 60.1–79.3) and an intensive MMC regimen (64.7%, 95% CI: 56.2–72.3) provided better CR rates in well-selected NMIBC patients. Comparable CR rates were noted irrespective of tumor multiplicity, whereas tumor size <5 mm was associated with a higher CR rate than tumor size ≥5 mm (odds ratio: 0.36, 95% CI: 0.17–0.79). The novel intensive MMC regimen resulted in lower rates of dysuria and urinary frequency than standard treatment.ConclusionsDespite the lack of long-term outcomes, chemoablation appears to be a promising treatment option for well-selected NMIBC patients and can potentially help avoid unnecessary TURBT, specifically in some elderly patients with intermediate-risk NMIBC. Further well-designed studies with larger cohorts are necessary to address the differential tolerability and long-term anticancer efficacy of this resurging approach.

AB - ContextThe ablative effect of intravesical therapy is known for decades. However, the clinical feasibility and efficacy of chemoablation for non–muscle-invasive bladder cancer (NMIBC) have not become accepted.ObjectiveTo assess the treatment outcomes of chemoablation for NMIBC and to compare its safety with that of the standard treatment, transurethral resection of bladder tumors (TURBT) followed by intravesical therapy.Evidence acquisitionMultiple databases were queried in July 2022 for studies investigating the complete response (CR) rates and adverse events in NMIBC patients treated with chemoablation using mitomycin C (MMC), gemcitabine, epirubicin, or bacillus Calmette-Guérin.Evidence synthesisOverall, 23 studies comprising 1199 patients were eligible for this meta-analysis. Among these studies, 20 assessed the efficacy of chemoablation and three compared the treatment outcomes of MMC chemoablation versus standard treatment. Among patients treated with weekly administration of any agent, the pooled CR rates at initial assessment were 50.9% (95% confidence interval [CI]: 45.9–55.9) for the marker lesion and 47.5% (95% CI: 36.5–58.7) for well-selected NMIBC (ie, small tumors and/or a small number of tumors). Novel regimens for chemoablation such as MMC-gel (70.6%, 95% CI: 60.1–79.3) and an intensive MMC regimen (64.7%, 95% CI: 56.2–72.3) provided better CR rates in well-selected NMIBC patients. Comparable CR rates were noted irrespective of tumor multiplicity, whereas tumor size <5 mm was associated with a higher CR rate than tumor size ≥5 mm (odds ratio: 0.36, 95% CI: 0.17–0.79). The novel intensive MMC regimen resulted in lower rates of dysuria and urinary frequency than standard treatment.ConclusionsDespite the lack of long-term outcomes, chemoablation appears to be a promising treatment option for well-selected NMIBC patients and can potentially help avoid unnecessary TURBT, specifically in some elderly patients with intermediate-risk NMIBC. Further well-designed studies with larger cohorts are necessary to address the differential tolerability and long-term anticancer efficacy of this resurging approach.

U2 - 10.1016/j.euf.2022.12.003

DO - 10.1016/j.euf.2022.12.003

M3 - SCORING: Review article

VL - 9

SP - 463

EP - 479

JO - EUR UROL FOCUS

JF - EUR UROL FOCUS

SN - 2405-4569

IS - 3

ER -