Efficacy of Surgery on the Primary Tumour in Patients with Metastatic Bladder Cancer: A Comprehensive Review.
Journal
Bladder cancer (Amsterdam, Netherlands)
ISSN: 2352-3735
Titre abrégé: Bladder Cancer
Pays: Netherlands
ID NLM: 101668567
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
03
2021
accepted:
19
01
2022
medline:
3
6
2022
pubmed:
3
6
2022
entrez:
12
7
2024
Statut:
epublish
Résumé
The benefit of surgery of the primary tumor in metastatic bladder cancer is unknown. Perform a comprehensive contemporary literature review on the benefit of surgery of the primary tumor in metastatic bladder cancer. Ovid MEDLINE, Ovid EMBASE, and Cochrane Library from January 1, 1990 to April 20, 2020 were queried for relevant articles published in English. Each article was evaluated by at least two content experts prior to inclusion which were blinded to the other's evaluation. A third content expert was used when there was not a unanimous decision. Additional articles were added at the discretion of the authors. Long-term survival is possible in patients with initially unresectable and/or limited metastatic disease. Multi-modal therapy with chemotherapy and surgery have the most favorable outcomes when compared to single treatment modalities in selected populations. Patients who demonstrate a robust response to pre-surgical therapy are likely to benefit the most from consolidative surgery. Patients with distant metastatic disease may benefit from consolidative surgery; however, this benefit may only be seen in those with metastatic disease limited to one site. Surgery of the primary tumor in metastatic bladder cancer either in the setting of surgery alone, consolidative therapy or coupled with adjuvant therapy may be beneficial in well selected patients and should generally be limited to those who have a response to primary chemotherapy. Randomized clinical control trials are needed to further our understanding of the role of surgery in metastatic bladder cancer.
Sections du résumé
BACKGROUND
BACKGROUND
The benefit of surgery of the primary tumor in metastatic bladder cancer is unknown.
OBJECTIVE
OBJECTIVE
Perform a comprehensive contemporary literature review on the benefit of surgery of the primary tumor in metastatic bladder cancer.
METHODS
METHODS
Ovid MEDLINE, Ovid EMBASE, and Cochrane Library from January 1, 1990 to April 20, 2020 were queried for relevant articles published in English. Each article was evaluated by at least two content experts prior to inclusion which were blinded to the other's evaluation. A third content expert was used when there was not a unanimous decision. Additional articles were added at the discretion of the authors.
RESULTS
RESULTS
Long-term survival is possible in patients with initially unresectable and/or limited metastatic disease. Multi-modal therapy with chemotherapy and surgery have the most favorable outcomes when compared to single treatment modalities in selected populations. Patients who demonstrate a robust response to pre-surgical therapy are likely to benefit the most from consolidative surgery. Patients with distant metastatic disease may benefit from consolidative surgery; however, this benefit may only be seen in those with metastatic disease limited to one site.
CONCLUSIONS
CONCLUSIONS
Surgery of the primary tumor in metastatic bladder cancer either in the setting of surgery alone, consolidative therapy or coupled with adjuvant therapy may be beneficial in well selected patients and should generally be limited to those who have a response to primary chemotherapy. Randomized clinical control trials are needed to further our understanding of the role of surgery in metastatic bladder cancer.
Identifiants
pubmed: 38993364
doi: 10.3233/BLC-211529
pii: BLC211529
pmc: PMC11181818
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Pagination
193-209Informations de copyright
© 2022 – The authors. Published by IOS Press.
Déclaration de conflit d'intérêts
Amy H. Lim, MD, PhD: no conflict of interest to report Vikram M. Narayan, MD: no conflict of interest to report Justin T. Matulay, MD: no conflict of interest to report Andrea Korokovic, MD: no conflict of interest to report Mary E. Westerman, MD: no conflict of interest to report Neema Navai, MD: no conflict of interest to report