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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.
Kang, Dong Hyuk; Cho, Kang Su; Moon, Young Joon; Chung, Doo Yong; Jung, Hae Do; Lee, Joo Yong.
  • Kang DH; Department of Urology, Inha University College of Medicine, Incheon, Korea.
  • Cho KS; Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
  • Moon YJ; Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
  • Chung DY; Department of Urology, Inha University College of Medicine, Incheon, Korea.
  • Jung HD; Department of Urology, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
  • Lee JY; Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
PLoS One ; 17(4): e0267410, 2022.
Article in English | MEDLINE | ID: covidwho-1883697
ABSTRACT

PURPOSE:

In the context of the COVID-19 outbreak, the European Association of Urology (EAU) guidelines Rapid Reaction Group provided recommendations to manage muscle invasive bladder cancer (MIBC) based on priority levels neoadjuvant chemotherapy (NAC) should be avoided for patients with T2-3N0M0 MIBC. This meta-analysis aims to evaluate the efficacy of NAC compared with radical cystectomy (RC) alone in improving the overall survival (OS) of patients with T2-4aN0M0 MIBC. MATERIALS AND

METHODS:

A systematic review was performed according to the PRISMA guidelines. The PubMed/Medline, EMBASE, and Cochrane Library databases were searched. The primary outcome was OS of patients with T2-4aN0M0 MIBC, and the secondary outcome was OS of patients with only T2N0M0 MIBC.

RESULTS:

Eight studies were included in this meta-analysis. Overall, the quality of all studies was relatively high, and little publication bias was demonstrated. The OS was significantly better in the NAC with RC group than in RC alone (HR, 0.79; 95% CI, 0.68-0.92; p = 0.002). A subgroup analysis was performed on only patients with T2N0M0 MIBC, and five studies were included. There was no difference in the OS between the NAC with RC and the RC alone groups (HR, 0.83; 95% CI, 0.69-1.01 p = 0.06).

CONCLUSIONS:

As recommended by the EAU guidelines Rapid Reaction Group, patients with T2N0M0 MIBC should strongly consider omitting NAC until the end of the COVID-19 pandemic. Whether to omit NAC in T3-4aN0M0 MIBC needs further discussion, and studies targeting only T2-3N0M0 MIBC are expected to proceed further.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Urology / Urinary Bladder Neoplasms / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urology / Urinary Bladder Neoplasms / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Female / Humans / Male Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article