The clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C after transurethral resection of bladder tumour in patients with nonmuscular invasive bladder cancer: A meta-analysis

Abstract

Background This review and meta-analysis aimed to systematically evaluate the clinical efficacy and safety of equipment-assisted intravesical instillation of mitomycin C (MMC) in patients with nonmuscular invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT). Methods The Embase, PubMed, CNKI, CBM, WANGFANG, VIP, Cochrane Library, and Clinicaltrial.com databases were searched for articles published before April 2022. The experimental group was treated with intravesical instillation of MMC assisted by equipment, including radiofrequency-induced thermochemotherapy, conductive thermochemical therapy, electromotive drug administration, or locoregional hyperthermia. The control group was treated with simple MMC perfusion. The outcomes of interest in the meta-analysis were recurrence, progression, side-effects, gross haematuria, and bladder irritation. Results A total of 15 studies that enrolled 1,190 patients were included in the meta-analysis. Compared to that of the control group, device-assisted intravesical instillation of MMC significantly reduced both tumour recurrence (odds ratio [OR] = 0.32, 95% confidence interval [CI] [0.24, 0.42], P <0.00001) and progression (OR = 0.29, 95% CI [0.12, 0.67], P = 0.004). There were no significant differences between the two groups in terms of safety (OR = 1.21, 95% CI [0.66,2.21], P = 0.54), bladder irritation (OR = 1.06, 95% CI [0.72,1.55], P = 0.78), or gross haematuria (OR = 1.11, 95% CI [0.64,1.94], P = 0.72). Conclusions Equipment-assisted intravesical instillation of MMC significantly reduced the recurrence and progression of patients with NMIBC who underwent TURBT and improved their quality of life. Given the significant heterogeneity in research quality and sample size among earlier studies, more prospective, multicentre, large sample randomized controlled trials are needed to supplement and verify this in the future.

The Efficacy and Safety of Hyperthermia Intravesical Chemotherapy in the Treatment of Non-Muscle-Invasive Bladder Cancer: A Meta-Analysis

“…Furthermore, several studies have indicated that bladder MMC HIVEC can potentially slow down the progression of the disease in patients who have a slow response to BCG treatment [26]. Additionally, Zhou et al's metaanalysis also supports the notion that HIVEC is more effective in reducing tumor recurrence and progression rates compared to conventional bladder perfusion chemotherapy [27].…”

A Robust Ferroptosis-Related Prognostic Model Associated With Immune Infiltration, Tumor Mutation Burden in Bladder Cancer

“…BC is a molecular heterogeneous malignancy (24). According to histopathological staging, the most common type is urothelial carcinoma (25). In the future, the incidence of BC will increase globally due to increased exposure to BC carcinogens and global aging(26).…”

Új minimálinvazív kezelési lehetőségek jó- és rosszindulatú fül-orr-gégészeti betegségekben nanoszerkezetű hatóanyag-leadó rendszerek alkalmazásával

“…A mitomicin C (MMC) a Streptomyces caespitosusból izolált, daganatellenes, antifibrotikus [17] és antibiotikus hatással rendelkező, vízben rosszul oldódó antiproliferatív bifunkciós alkilezőszer, amely a DNS-láncokhoz kötődve gátolja a DNS-szintézist [18]. A közismert kemoterápiás szerként történő alkalmazáson (gyomor- [19], mell- [20] és hólyagrák [21]) kívül az MMC-t széles körben alkalmazzák antifibrotikus gyógyszerként szemészeti [22,23] és fej-nyaki [24] műtétek után a hegszövetképződés megelőzésére. Hosszú ideig történő intravénás alkalmazása során mellékhatásként vese-, gyomor-bél rendszeri és csontvelő-károsodást okozhat.…”