Effect of neoadjuvant chemotherapy on overall survival of patients with T2-4aN0M0 bladder cancer: A systematic review and meta-analysis according to EAU COVID-19 recommendation

Kang, Dong Hyuk; Moon, Young Joon; Chung, Doo Yong; Jung, Hae Do; Lee, Joo Yong

doi:10.1371/journal.pone.0267410

Cited by 7 publications

(5 citation statements)

References 32 publications

(33 reference statements)

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“…During the COVID-19 pandemic, management also has been delayed for muscle-invasive bladder cancer (MIBC). According to EAU recommendations, Kang et al conducted systematic review and meta-analysis to evaluate the efficacy of neoadjuvant chemotherapy (NAC) compared with radical cystectomy (RC) alone in improving the overall survival (OS) of patients with T2-4aN0M0 MIBC [ 40 ]. The OS was significantly better in the NAC with RC group than in the RC alone group.…”

Section: Discussionmentioning

confidence: 99%

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

et al. 2022

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Purpose During the coronavirus disease 2019 (COVID-19) pandemic, the European Association of Urology (EAU) recommended that courses of intravesical bacillus Calmette-Guérin (BCG) therapy lasting more than 1 year could be safely terminated for patients with high-risk non-muscle-invasive bladder cancer (NMIBC). Thus, we conducted a systematic review and network meta-analysis according to EAU’s COVID-19 recommendations. Materials and methods A systematic review was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We conducted a network meta-analysis of recurrence rate in patients with NMIBC receiving induction therapy (M0) and those receiving maintenance therapy lasting 1 year (M1) and more than 1 year (M2). Results Nineteen studies of 3,957 patients were included for the network meta-analysis. In a node-split forest plot using Bayesian Markov Chain Monte Carlo (MCMC) modeling, there were no differences between the M1 and M2 groups in recurrence rate [odds ratio (OR) 0.95 (0.73–1.2)]. However, recurrence rate in the M0 group was higher than that in the M1 [OR 1.9 (1.5–2.5)] and M2 [OR 2.0 (1.7–2.4)] groups. P-score tests using frequentist inference to rank the treatments in the network demonstrated that the therapy used in the M2 group (P-score 0.8701) was superior to that used in the M1 (P-score 0.6299) and M0 groups (P-score 0). In rank-probability tests using MCMC modeling, the M2 group showed the highest rank, followed by the M1 and M0 groups. Conclusion In the network meta-analysis, there were no differences between those receiving BCG maintenance therapies in terms of recurrence rate. In the rank tests, therapy lasting more than 1-year appears to be most effective. During the COVID-19 pandemic, 1-year maintenance therapy can be used, but after the COVID-19 pandemic, therapy lasting more than 1-year could be beneficial.

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Section: Discussionmentioning

confidence: 99%

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

et al. 2022

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“…The European Association of Urology (EAU) Surgeons Guide Rapid Response Group provides a priority-based management recommendation for MIBC: patients with cT2-3N0M0 MIBC should refrain from using NAC during the COVID-19 pandemic. This suggestion has also been validated by a meta-analysis that comprised eight studies ( 26 ).…”

Section: Neoadjuvant Chemotherapy (Nac)mentioning

confidence: 74%

A narrative review of management of muscle-invasive bladder cancer perioperative period: will continuous and combined treatment be the new trend?

Lan,

Ran,

Gao

et al. 2024

Transl Androl Urol

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Background and Objective With the emergence of immunotherapy and targeted therapies, there are more options for the perioperative period management of muscle-invasive bladder cancer (MIBC), and various types of clinical studies are emerging, leading to the need to explore ways to choose the optimal treatment modality. This review aims to synthesize past and present treatment modalities and to explore future trends in the perioperative period cares of MIBC for the benefit of clinical practitioners. Methods A non-systematic, literature search was conducted between March 5, 2023 and November 30, 2023 on PubMed using “perioperative period”, “MIBC”, “chemotherapy”, “radiotherapy”, “immunotherapy”, “targeted treatment” and “combination” as keywords, along with a search for ongoing clinical studies that were related to the perioperative period of MIBC on classic.clinicaltrials.gov, some latest conference abstracts were also included as references. Key Content and Findings The trend towards benefit from adjuvant chemotherapy in perioperative chemotherapy is gradually being recognized. Neoadjuvant immunotherapy, including single-agent immunization, like programmed cell death protein 1 (PD-1) inhibitors, programmed cell death 1 ligand 1 (PD-L1) inhibitors and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitors, and double-immunization, has been confirmed by several clinical studies to be beneficial to clinical remission rates, and the combination regimen is superior to single-agent therapy. Targeted therapies such as antibody-drug conjugate (ADC) are entering MIBC perioperative studies. Multiple sequential and combination clinical studies are gradually disclosing preliminary data on efficacy and safety. Conclusions Immunotherapy would become an essential perioperative treatment for MIBC, and continuous and integrated perioperative management may become the MIBC treatment mode of the future. ADC medicines will also be a hot research focus in the coming years.

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“…Of all urogenital cancers, bladder and kidney cancer have the most diverse variety of treatments, resulting in a substantial complexity to clinical decision making during the pandemic added to the high sensibility of these patients to SARS-CoV-2 19 20. Hence, transurethral resection of bladder tumour is a diagnostic procedure that should not be delayed.…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary for patients with intermediate risk or poor-risk prognosis of metastatic kidney cancer, surgical therapy can often be deferred in favour of effective systemic therapy, which does not require hospital admissions 20. However, in any oncological disease, the diagnosis and timely treatment should not be compromised 19 22…”

Section: Discussionmentioning

confidence: 99%

Consequences of SARS-CoV-2 pandemic on urological surgery in France: a nationwide analysis of the healthcare system database

Robert

Bernhard²,

Capon³

et al. 2022

BMJ Open

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The SARS-CoV-2 outbreak overwhelmed the healthcare systems worldwide. Saturation of hospitals and the risk of contagion led to a reduction in the care of other diseases.ObjectiveTo determine the impact of SARS-CoV-2 pandemic on urological surgery in France during the year 2020.Design, setting and participantsAn observational descriptive study was conducted on anonymised data collected from the national healthcare database established each year as part of the Program for the Medicalization of Information Systems in Medicine, Surgery, Obstetrics and Odontology.InterventionNone.Primary and secondary outcome measuresWe gathered the number of urology surgical procedures carried out between 2010 and 2019, and we observed the difference between the forecast and actual number of urological surgeries performed in 2020.ResultsUrological surgeries decreased by 11.4%, non-oncological surgeries being more affected (−13.1%) than oncological ones (−4.1%). Among the most relevant surgeries, female urinary incontinence (−44.7%) and benign prostatic hyperplasia (−20.8%) were the most impacted ones, followed by kidney cancer (−9%), urolithiasis (−8.7%), radical cystectomy for bladder cancer (−6.1%), prostate cancer (−3.6%) and transurethral resection of bladder tumour (−2%). Public hospitals had a more reduced activity (−17.7%) than private ones (−9.1%). Finally, the distribution of the reduction in urological activities by region did not correspond to the regional burden of SARS-CoV-2.ConclusionsUrological care was severely affected during SARS-CoV-2 pandemic. Even if oncological surgeries were prioritised, the longer it takes to receive appropriate care, the greater the risk on survival impact.Trial registrationThe data collection and analysis was authorised by the French Data Protection Authority (CNIL) under the number1 861 282v2.

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Effect of neoadjuvant chemotherapy on overall survival of patients with T2-4aN0M0 bladder cancer: A systematic review and meta-analysis according to EAU COVID-19 recommendation

Cited by 7 publications

References 32 publications

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

A narrative review of management of muscle-invasive bladder cancer perioperative period: will continuous and combined treatment be the new trend?

Consequences of SARS-CoV-2 pandemic on urological surgery in France: a nationwide analysis of the healthcare system database

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