摘要
目的比较保留膀胱手术＋术后化疗与根治性手术治疗肌层浸润性膀胱癌的预后。方法检索保留膀胱手术＋术后化疗与根治性手术治疗肌层浸润性膀胱癌（muscle-invasive bladder cancer，MIBC）的对照研究，比较两种治疗方案的术后5年生存率，计算合并优势比（OR）和95％CI。结果共纳入7项研究，累积876例患者。1组研究的OR=I．03，95％CI为1．03（0．52～2．02），4组研究的OR及其95％CI〈l，2组研究的OR及其95％CI〉1；7个研究的总OR=1.05，95％CI为1．05（0．53-2．06），跨过“无差异线”，故认为根治性膀胱全切术（radical cystectomy，RC）与保留膀胱的综合治疗预后差异无统计学意义（Z=0．13，P=0．89）。结论对于部分肌层浸润性膀胱癌患者，保留膀胱的综合治疗不会降低患者的5年生存率，且能保留患者膀胱的正常功能，提高了患者的生存质量，但适应证需严格把握。
Objective To compare the prognosis of bladder preservation surgery ＋ postoperative chemotherapy with that of radical cystectomy in patients with muscle-invasive bladder cancer. Method Controlled trials that compare bladder preservation surgery ＋ postoperative chemotherapy with radical cystectomy in patients with muscle-invasive bladder cancer were retrieved, with the 5-year postoperative survivals compared and odds ratio （OR） and 95% confidence interval （95% CI） calculated. Result 7 trials （876 patients in total） were included. The meta-analysis results showed that： one tri- al had an OR of 1.03 and a 95% CI of 1.03 （0.52-2.02）; in four other trials, the corresponding OR and 95% CI were all 〈 1; OR and 95% CI of the remaining two trials were 〉 1; the total OR of the 7 trials was 1.05, and the 95% CI was 1.05 （0.53-2.06）, suggesting no statistical difference in prognosis existing between comprehensive bladder preservation thera- py and radical cystectomy （Z=0.13, P=0.89）. Conclusion For some patients with muscle-invasive bladder cancer, the comprehensive bladder preservation therapy does not reduce the 5-year survival rate, can retain normal bladder function, and improve quality of life. However, the indications should be carefully considered.
出处
《癌症进展》
2016年第2期106-108,共3页
Oncology Progress
关键词
肌层浸润性膀胱癌
保留膀胱手术
化疗
膀胱切除术
荟萃分析
muscle-invasive bladder cancer
bladder preservation surgery
chemotherapy
radical cystectomy
meta-analysis
