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Inicio Actas Urológicas Españolas (English Edition) Effect of intravesical mitomycin compared with gemcitabine on the treatment non-...
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Vol. 47. Issue 2.
Pages 92-98 (March 2023)
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Vol. 47. Issue 2.
Pages 92-98 (March 2023)
Original article
Effect of intravesical mitomycin compared with gemcitabine on the treatment non-muscle invasive bladder cancer: A meta-analysis
Efecto de la mitomicina en comparación con la gemcitabina intravesical en el tratamiento del cáncer de vejiga sin invasión muscular: metaanálisis
W. Cheng, Y. Zhou, X. Chu, S. Huang, X. Zheng
Corresponding author
zhenghao8678@outlook.com

Corresponding author.
, H. Zheng
Department of Urology, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, Guangdong, China
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Abstract
Introduction

We performed a meta-analysis to evaluate the effect of intravesical mitomycin compared with gemcitabine on the treatment of non-muscle invasive bladder cancer.

Methods

A systematic literature search up to November 2021 was done and 6 studies included 389 subjects with non-muscle invasive bladder cancer at the start of the study; 197 of them were provided with intravesical-mitomycin and 192 with intravesical gemcitabine. The studies reported the relationships about the effect of intravesical mitomycin compared with gemcitabine on the treatment of non-muscle invasive bladder cancer. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the effect of intravesical mitomycin compared with gemcitabine on the treatment of non-muscle invasive bladder cancer using the dichotomous method with a random or fixed-effect model.

Results

Intravesical mitomycin had significantly higher recurrence rates (OR, 2.41; 95% CI, 1.43–4.08, p=0.001) and chemical cystitis (OR, 4.39; 95% CI, 2.27–8.51, p<0.001) compared to intravesical gemcitabine in subjects with non-muscle invasive bladder cancer. However, intravesical mitomycin had no significant difference in its effect on hematuria (OR, 1.71; 95% CI, 0.68–4.33, p=0.26), skin reaction (OR, 2.04; 95% CI, 0.59–7.07, p=0.26), and liver and kidney functions damage (OR, 1.96; 95% CI, 0.35–10.96, p=0.44) compared to intravesical gemcitabine in subjects with non-muscle invasive bladder cancer.

Conclusions

Intravesical mitomycin had significantly higher recurrence rates and chemical cystitis and no significant difference in its effect on hematuria, skin reaction, and liver and kidney functions damage compared to intravesical gemcitabine in subjects with non-muscle invasive bladder cancer. Further studies are required to validate these findings.

Keywords:
Intravesical mitomycin
Non-muscle invasive bladder cancer
Intravesical gemcitabine
Recurrence rates
Chemical cystitis
Hematuria
Resumen
Introducción

Se realizó un metaanálisis para evaluar el efecto de la mitomicina intravesical en comparación con la gemcitabina en el tratamiento del cáncer de vejiga sin invasión muscular.

Métodos

Se realizó una búsqueda bibliográfica sistemática hasta noviembre de 2021 y 6 estudios incluyeron 389 sujetos con cáncer de vejiga no invasivo al músculo al inicio del estudio; 197 de ellos recibieron mitomicina intravesical y 192gemcitabina intravesical. Se informó de las relaciones sobre el efecto de la mitomicina intravesical en comparación con la gemcitabina en el tratamiento del cáncer de vejiga no invasivo al músculo. Se calculó el odds ratio (OR) con intervalos de confianza (IC) del 95% para evaluar el efecto de la mitomicina en comparación con el de la gemcitabina intravesical en el tratamiento del cáncer de vejiga no invasivo mediante el método dicotómico con un modelo de efectos aleatorios o fijos.

Resultados

La mitomicina intravesical obtuvo tasas significativamente mayores de recidiva (OR, 2,41; IC del 95%, 1,43–4,08, p=0,001) y de cistitis química (OR, 4,39; IC del 95%, 2,27–8,51, p<0,001) en comparación con la gemcitabina intravesical en sujetos con cáncer de vejiga no invasivo. Sin embargo, la mitomicina intravesical no mostró diferencias significativas en su efecto sobre la hematuria (OR, 1,71; IC del 95%, 0,68–4,33, p=0,26), reacciones cutáneas (OR, 2,04; IC del 95%, 0,59–7,07, p=0,26) y daños en la función hepática y renal (OR, 1,96; IC del 95%, 0,35–10,96, p=0,44) en comparación con la gemcitabina intravesical en sujetos con cáncer de vejiga no invasivo al músculo.

Conclusiones

La mitomicina intravesical tuvo tasas de recidiva y cistitis química significativamente mayores y no hubo diferencias significativas en su efecto sobre la hematuria, la reacción cutánea y el daño de la función hepática y renal en comparación con la gemcitabina intravesical en sujetos con cáncer de vejiga no invasivo al músculo. Se necesitan más estudios para validar estos resultados.

Palabras clave:
Mitomicina intravesical
Cáncer de vejiga sin invasión muscular
Gemcitabina intravesical
Tasas de recurrencia
Cistitis química
Hematuria

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