PD63-07 INTRAVESICAL THERAPY IN PATIENTS WITH INTERMEDIATE-RISK NON-MUSCLE-INVASIVE BLADDER CANCER: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS OF ONCOLOGIC OUTCOMES

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive III (PD63)1 Sep 2021PD63-07 INTRAVESICAL THERAPY IN PATIENTS WITH INTERMEDIATE-RISK NON-MUSCLE-INVASIVE BLADDER CANCER: A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS OF ONCOLOGIC OUTCOMES Ekaterina Laukhtina, Mohammad Abufaraj, Abdallah Al-Ani, Mustafa Rami Ali, Keiichiro Mori, Marco Moschini, Fahad Quhal, Reza Sari Motlagh, Benjamin Pradere, Victor M. Schuettfort, Hadi Mostafaei, Satoshi Katayama, Nico С. Grossmann, Harun Fajkovic, Francesco Soria, Dmitry Enikeev, and Shahrokh F. Shariat Ekaterina LaukhtinaEkaterina Laukhtina More articles by this author , Mohammad AbufarajMohammad Abufaraj More articles by this author , Abdallah Al-AniAbdallah Al-Ani More articles by this author , Mustafa Rami AliMustafa Rami Ali More articles by this author , Keiichiro MoriKeiichiro Mori More articles by this author , Marco MoschiniMarco Moschini More articles by this author , Fahad QuhalFahad Quhal More articles by this author , Reza Sari MotlaghReza Sari Motlagh More articles by this author , Benjamin PradereBenjamin Pradere More articles by this author , Victor M. SchuettfortVictor M. Schuettfort More articles by this author , Hadi MostafaeiHadi Mostafaei More articles by this author , Satoshi KatayamaSatoshi Katayama More articles by this author , Nico С. GrossmannNico С. Grossmann More articles by this author , Harun FajkovicHarun Fajkovic More articles by this author , Francesco SoriaFrancesco Soria More articles by this author , Dmitry EnikeevDmitry Enikeev More articles by this author , and Shahrokh F. ShariatShahrokh F. Shariat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002107.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: This systematic review and network meta-analysis (NMA) aimed to summarize the available evidence on the oncologic outcomes of intravesical therapy in patients with intermediate-risk NMIBC. METHODS: The MEDLINE, EMBASE, and ‘clinicaltrials.gov’ databases were searched in October 2020, according to the PRISMA statement. Studies were deemed eligible if they reported on oncologic outcomes in intermediate-risk NMIBC patients treated with TURBT with and without intravesical chemotherapy or BCG immunotherapy. For the assessment of 5-year recurrence risk, arm-based analyses were performed to estimate the odds ratio (OR) of the 5-year recurrence risk and 95% credible interval (CI) from the available data presented in the included manuscripts. The relative ranking of the different treatments for each outcome was estimated using the p-score, which can be considered a frequentist analog to the surface under the cumulative ranking curves. RESULTS: Twelve studies were included in a qualitative synthesis; three were deemed eligible for a quantitative synthesis. A NMA of five different regimens was conducted for the association of treatment with the 5-year recurrence risk: 1) chemotherapy as standard regimen; 2) chemotherapy as delayed regimen; 3) chemotherapy as extended regimen; 4) immunotherapy in full dose; 5) immunotherapy in reduced dose. Chemotherapy with maintenance was associated with a lower likelihood of 5-year recurrence than chemotherapy without maintenance (OR:0.51, 95%CI:0.26–1.03). In contrast, chemotherapy delayed regimen was not associated with a significantly lower likelihood of the 5-year recurrence risk compared to standard chemotherapy (OR:0.92, 95%CI:0.58–1.48). Immunotherapy, regardless of full or reduced dose regimen, was not associated with a significantly lower likelihood of the 5-year recurrence risk as compared with chemotherapy without maintenance (OR:0.90, 95%CI:0.39–2.11, and OR:0.93, 95%CI:0.40–2.19, respectively). The analysis of the treatment ranking found that chemotherapy with maintenance had the lowest 5-year recurrence risk (P score: 0.9666). CONCLUSIONS: Our analysis indicates that chemotherapy with maintenance regimen confers a superior oncologic benefit in terms of the 5-year recurrence risk compared to chemotherapy without maintenance in patients with intermediate-risk NMIBC. Regardless of dose regimen, immunotherapy with BCG does not appear to be superior to chemotherapy in patients with intermediate-risk NMIBC in term of disease recurrence. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1140-e1141 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ekaterina Laukhtina More articles by this author Mohammad Abufaraj More articles by this author Abdallah Al-Ani More articles by this author Mustafa Rami Ali More articles by this author Keiichiro Mori More articles by this author Marco Moschini More articles by this author Fahad Quhal More articles by this author Reza Sari Motlagh More articles by this author Benjamin Pradere More articles by this author Victor M. Schuettfort More articles by this author Hadi Mostafaei More articles by this author Satoshi Katayama More articles by this author Nico С. Grossmann More articles by this author Harun Fajkovic More articles by this author Francesco Soria More articles by this author Dmitry Enikeev More articles by this author Shahrokh F. Shariat More articles by this author Expand All Advertisement Loading ...