Efficacy and safety of transcatheter arterial chemoembolization combined with transurethral resection of bladder tumor for muscle-invasive bladder cancer: a meta-analysis_West China Medical Journal

Authors：

LAI Jingling , LU Jianxin , WANG Han , WANG Ziqiang , GUO Yinuo , SHI Peiqi , ZHU He , QI Xiao , PANG Ran ,  AN Yifang

Department of Urology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China;

Corresponding?author：

AN Yifang, Email: anyifang2019@163.com

Keywords：

Muscle-invasive bladder cancer; transcatheter arterial chemoembolization; transurethral resection of bladder tumor; randomized controlled trial; meta-analysis

DOI：

10.7507/1002-0179.202310183

Video：

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Objective To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with transurethral resection of bladder tumor (TURBT) for muscle-invasive bladder cancer (MIBC). Methods China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Web of Science, and Cochrane Library were searched from the establishment of databases until December 2023. All randomized controlled trials of TACE combined with TURBT for MIBC were collected and subjected to meta-analysis using RevMan 5.4 software. Results A total of 7 studies were included, involving 490 patients, with 246 in the TACE+TURBT group and 244 in the TURBT group. The meta-analysis results showed that compared with TURBT, TACE+TURBT had certain advantages in reducing recurrence rate [relative risk (RR)=0.49, 95% confidence interval (CI) (0.35, 0.68)], improving survival rate [RR=1.16, 95%CI (1.07, 1.27)], shortening surgical time [standardized mean difference (SMD)=?4.97, 95%CI (?7.54, ?2.40)], reducing intraoperative bleeding [SMD=?4.19, 95%CI (?5.78, ?2.60)], and improving quality of life [SMD=4.51, 95%CI (2.15, 6.86)]. The adverse reactions of the two groups were similar. Conclusions Existing evidence suggests that TACE may reduce intraoperative bleeding and shorten surgical time to help achieve maximum TURBT. TACE combined with TURBT may be superior to simple TURBT in terms of tumor recurrence rate and survival rate. TACE combined with TURBT can benefit MIBC patients in bladder-preserving treatment plans.

Citation： LAI Jingling, LU Jianxin, WANG Han, WANG Ziqiang, GUO Yinuo, SHI Peiqi, ZHU He, QI Xiao, PANG Ran, AN Yifang. Efficacy and safety of transcatheter arterial chemoembolization combined with transurethral resection of bladder tumor for muscle-invasive bladder cancer: a meta-analysis. West China Medical Journal, 2025, 40(1): 68-73. doi: 10.7507/1002-0179.202310183 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Brierley JD, Gospodarowicz MK, Wittekind C. UICC TNM classification of malignant tumours. 8th ed. Chichester: Wiley-Blackwell, 2017.
3.	譚智勇, 付什, 欒婷, 等. 肌層浸潤性膀胱癌保留膀胱綜合治療的研究進展. 中華泌尿外科雜志, 2022, 43(6): 464-468.
4.	黃健, 張旭. 中國泌尿外科和男科疾病診斷治療指南. 北京: 科學出版社, 2022: 64.
5.	中國腫瘤醫院泌尿腫瘤協作組. 中國膀胱癌保膀胱治療多學科診治協作共識. 中華腫瘤雜志, 2022, 44(3): 209-218.
6.	Wallace S, Charnsangavej C, Carrasco CH, et al. Infusion-embolization. Cancer, 1984, 54(Suppl 11): 2751-2765.
7.	王震霆, 羅曼, 汪智峰, 等. TURBt 術前髂內動脈灌注化療治療 T2、T3 期肌層浸潤性膀胱癌的療效及其對患者術后生活質量的影響. 海南醫學, 2017, 28(18): 2951-2955.
8.	景中民, 盧學仁, 徐海亮, 等. 單純 TURBt 術及聯合術前髂內動脈化療栓塞術治療肌層浸潤性膀胱癌的療效及術后并發癥分析. 哈爾濱醫藥, 2017, 37(3): 262, 244.
9.	秦悅. 經尿道膀胱腫瘤電切術聯合髂內動脈栓塞化療治療高齡高危浸潤性膀胱癌患者的效果. 中國民康醫學, 2020, 32(9): 46-48.
10.	邱騰, 胡小桃. 經尿道膀胱腫瘤切除聯合栓塞化療治療肌層浸潤性膀胱癌的臨床療效分析. 齊齊哈爾醫學院學報, 2019, 40(11): 1403-1405.
11.	朱智能, 高小玲, 黃遂斌, 等. 髂內動脈化療栓塞聯合雙極等離子電切術治療大體積膀胱癌的臨床應用. 介入放射學雜志, 2020, 29(6): 572-576.
12.	張國穎. 髂內動脈化療栓塞與經尿道膀胱腫瘤電切術相結合對晚期膀胱癌的臨床分析. 中外醫療, 2019, 38(6): 70-72.
13.	陳志華, 程全勝, 周榮華, 等. 髂內動脈栓塞化療聯合 TURBt 治療因高齡高危不能耐受根治性膀胱全切的肌層浸潤性膀胱癌的臨床價值體會. 中國保健營養, 2018, 28(32): 63-64.
14.	Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ, 1992, 305(6846): 160-164.
15.	Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
16.	羅健, 孫燕, 吳冠青, 等. 癌癥患者生活質量調查表的編制及試測. 實用腫瘤雜志, 1996(6): 252-255.
17.	Teoh JY, Kamat AM, Black PC, et al. Recurrence mechanisms of non-muscle-invasive bladder cancer - a clinical perspective. Nat Rev Urol, 2022, 19(5): 280-294.
18.	Tokuyama N, Saito A, Muraoka R, et al. Prediction of non-muscle invasive bladder cancer recurrence using machine learning of quantitative nuclear features. Mod Pathol, 2022, 35(4): 533-538.
19.	Huddart RA, Birtle A, Maynard L, et al. Clinical and patient-reported outcomes of SPARE - a randomised feasibility study of selective bladder preservation versus radical cystectomy. BJU Int, 2017, 120(5): 639-650.
20.	Chen C, Kim PH, Shin JH, et al. Transcatheter arterial embolization for intractable, nontraumatic bladder hemorrhage in cancer patients: a single-center experience and systematic review. Jpn J Radiol, 2021, 39(3): 273-282.
21.	Ghahestani SM, Shakhssalim N. Palliative treatment of intractable hematuria in context of advanced bladder cancer: a systematic review. Urol J, 2009, 6(3): 149-156.
22.	Azuma H, Inamoto T, Ibuki N, et al. Novel bladder preservation therapy for locally invasive bladder cancer: combined therapy using balloon-occluded arterial infusion of anticancer agent and hemodialysis with concurrent radiation. Int J Oncol, 2010, 37(4): 773-785.
23.	朱赫, 龐然, 盧建新. 肌層浸潤性膀胱癌的中西醫結合保留膀胱治療. 重慶醫科大學學報, 2023, 48(8): 875-879.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Brierley JD, Gospodarowicz MK, Wittekind C. UICC TNM classification of malignant tumours. 8th ed. Chichester: Wiley-Blackwell, 2017.
3. 譚智勇, 付什, 欒婷, 等. 肌層浸潤性膀胱癌保留膀胱綜合治療的研究進展. 中華泌尿外科雜志, 2022, 43(6): 464-468.
4. 黃健, 張旭. 中國泌尿外科和男科疾病診斷治療指南. 北京: 科學出版社, 2022: 64.
5. 中國腫瘤醫院泌尿腫瘤協作組. 中國膀胱癌保膀胱治療多學科診治協作共識. 中華腫瘤雜志, 2022, 44(3): 209-218.
6. Wallace S, Charnsangavej C, Carrasco CH, et al. Infusion-embolization. Cancer, 1984, 54(Suppl 11): 2751-2765.
7. 王震霆, 羅曼, 汪智峰, 等. TURBt 術前髂內動脈灌注化療治療 T2、T3 期肌層浸潤性膀胱癌的療效及其對患者術后生活質量的影響. 海南醫學, 2017, 28(18): 2951-2955.
8. 景中民, 盧學仁, 徐海亮, 等. 單純 TURBt 術及聯合術前髂內動脈化療栓塞術治療肌層浸潤性膀胱癌的療效及術后并發癥分析. 哈爾濱醫藥, 2017, 37(3): 262, 244.
9. 秦悅. 經尿道膀胱腫瘤電切術聯合髂內動脈栓塞化療治療高齡高危浸潤性膀胱癌患者的效果. 中國民康醫學, 2020, 32(9): 46-48.
10. 邱騰, 胡小桃. 經尿道膀胱腫瘤切除聯合栓塞化療治療肌層浸潤性膀胱癌的臨床療效分析. 齊齊哈爾醫學院學報, 2019, 40(11): 1403-1405.
11. 朱智能, 高小玲, 黃遂斌, 等. 髂內動脈化療栓塞聯合雙極等離子電切術治療大體積膀胱癌的臨床應用. 介入放射學雜志, 2020, 29(6): 572-576.
12. 張國穎. 髂內動脈化療栓塞與經尿道膀胱腫瘤電切術相結合對晚期膀胱癌的臨床分析. 中外醫療, 2019, 38(6): 70-72.
13. 陳志華, 程全勝, 周榮華, 等. 髂內動脈栓塞化療聯合 TURBt 治療因高齡高危不能耐受根治性膀胱全切的肌層浸潤性膀胱癌的臨床價值體會. 中國保健營養, 2018, 28(32): 63-64.
14. Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ, 1992, 305(6846): 160-164.
15. Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst, 1993, 85(5): 365-376.
16. 羅健, 孫燕, 吳冠青, 等. 癌癥患者生活質量調查表的編制及試測. 實用腫瘤雜志, 1996(6): 252-255.
17. Teoh JY, Kamat AM, Black PC, et al. Recurrence mechanisms of non-muscle-invasive bladder cancer - a clinical perspective. Nat Rev Urol, 2022, 19(5): 280-294.
18. Tokuyama N, Saito A, Muraoka R, et al. Prediction of non-muscle invasive bladder cancer recurrence using machine learning of quantitative nuclear features. Mod Pathol, 2022, 35(4): 533-538.
19. Huddart RA, Birtle A, Maynard L, et al. Clinical and patient-reported outcomes of SPARE - a randomised feasibility study of selective bladder preservation versus radical cystectomy. BJU Int, 2017, 120(5): 639-650.
20. Chen C, Kim PH, Shin JH, et al. Transcatheter arterial embolization for intractable, nontraumatic bladder hemorrhage in cancer patients: a single-center experience and systematic review. Jpn J Radiol, 2021, 39(3): 273-282.
21. Ghahestani SM, Shakhssalim N. Palliative treatment of intractable hematuria in context of advanced bladder cancer: a systematic review. Urol J, 2009, 6(3): 149-156.
22. Azuma H, Inamoto T, Ibuki N, et al. Novel bladder preservation therapy for locally invasive bladder cancer: combined therapy using balloon-occluded arterial infusion of anticancer agent and hemodialysis with concurrent radiation. Int J Oncol, 2010, 37(4): 773-785.
23. 朱赫, 龐然, 盧建新. 肌層浸潤性膀胱癌的中西醫結合保留膀胱治療. 重慶醫科大學學報, 2023, 48(8): 875-879.

West China Medical Journal

Efficacy and safety of transcatheter arterial chemoembolization combined with transurethral resection of bladder tumor for muscle-invasive bladder cancer: a meta-analysis

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