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Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review

PURPOSE: Radical cystectomy currently is the treatment of choice in muscle-invasive bladder cancer. However, cystectomy is associated with considerable morbidity. Bladder sparing treatment consists of transurethral resection of the tumor (with or without partial cystectomy), external beam radiothera...

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Autores principales: Bos, Manouk K., Marmolejo, Rafael Ordoñez, Rasch, Coen R.N., Pieters, Bradley R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105649/
https://www.ncbi.nlm.nih.gov/pubmed/25097561
http://dx.doi.org/10.5114/jcb.2014.43777
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author Bos, Manouk K.
Marmolejo, Rafael Ordoñez
Rasch, Coen R.N.
Pieters, Bradley R.
author_facet Bos, Manouk K.
Marmolejo, Rafael Ordoñez
Rasch, Coen R.N.
Pieters, Bradley R.
author_sort Bos, Manouk K.
collection PubMed
description PURPOSE: Radical cystectomy currently is the treatment of choice in muscle-invasive bladder cancer. However, cystectomy is associated with considerable morbidity. Bladder sparing treatment consists of transurethral resection of the tumor (with or without partial cystectomy), external beam radiotherapy, and brachytherapy. The purpose of this study is to compare bladder preservation with brachytherapy to cystectomy by a systematic review. MATERIAL AND METHODS: A systematic review was conducted using PubMed electronic database. Article selection was done independently by two authors. Data were extracted on cause-specific survival and overall survival at 2, 5, and 10 years. Comparison of the two treatment modalities was done by a Weibull survival analysis with metaregression analysis and estimation of Hazard Ratio's (HR's) with 95% confidence intervals (CI). RESULTS: Large differences in tumor staging and tumor grading were found between cystectomy and bladder sparing series. The adjusted HR's for cause-specific survival and overall survival were 1.27 (95% CI: 1.15-1.40) and 0.85 (95% CI: 0.84-0.87), respectively for bladder sparing relative to radical cystectomy. CONCLUSIONS: Robustness of the analysis is hampered by the retrospective character of the study and differences in patient characteristics. For selected cases, bladder sparing by brachytherapy leads to at least similar overall survival compared to radical cystectomy for muscle invasive bladder cancer.
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spelling pubmed-41056492014-08-05 Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review Bos, Manouk K. Marmolejo, Rafael Ordoñez Rasch, Coen R.N. Pieters, Bradley R. J Contemp Brachytherapy Review Paper PURPOSE: Radical cystectomy currently is the treatment of choice in muscle-invasive bladder cancer. However, cystectomy is associated with considerable morbidity. Bladder sparing treatment consists of transurethral resection of the tumor (with or without partial cystectomy), external beam radiotherapy, and brachytherapy. The purpose of this study is to compare bladder preservation with brachytherapy to cystectomy by a systematic review. MATERIAL AND METHODS: A systematic review was conducted using PubMed electronic database. Article selection was done independently by two authors. Data were extracted on cause-specific survival and overall survival at 2, 5, and 10 years. Comparison of the two treatment modalities was done by a Weibull survival analysis with metaregression analysis and estimation of Hazard Ratio's (HR's) with 95% confidence intervals (CI). RESULTS: Large differences in tumor staging and tumor grading were found between cystectomy and bladder sparing series. The adjusted HR's for cause-specific survival and overall survival were 1.27 (95% CI: 1.15-1.40) and 0.85 (95% CI: 0.84-0.87), respectively for bladder sparing relative to radical cystectomy. CONCLUSIONS: Robustness of the analysis is hampered by the retrospective character of the study and differences in patient characteristics. For selected cases, bladder sparing by brachytherapy leads to at least similar overall survival compared to radical cystectomy for muscle invasive bladder cancer. Termedia Publishing House 2014-06-28 2014-06 /pmc/articles/PMC4105649/ /pubmed/25097561 http://dx.doi.org/10.5114/jcb.2014.43777 Text en Copyright © 2014 Termedia http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Paper
Bos, Manouk K.
Marmolejo, Rafael Ordoñez
Rasch, Coen R.N.
Pieters, Bradley R.
Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title_full Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title_fullStr Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title_full_unstemmed Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title_short Bladder preservation with brachytherapy compared to cystectomy for T1-T3 muscle-invasive bladder cancer: a systematic review
title_sort bladder preservation with brachytherapy compared to cystectomy for t1-t3 muscle-invasive bladder cancer: a systematic review
topic Review Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105649/
https://www.ncbi.nlm.nih.gov/pubmed/25097561
http://dx.doi.org/10.5114/jcb.2014.43777
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