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.	谭智勇, 付什, 栾婷, 等. 肌层浸润性膀胱癌保留膀胱综合治疗的研究进展. 中华泌尿外科杂志, 2022, 43(6): 464-468.
4.	黄健, 张旭. 中国泌尿外科和男科疾病诊断治疗指南. 北京: 科学出版社, 2022: 64.
5.	中国肿瘤医院泌尿肿瘤协作组. 中国膀胱癌保膀胱治疗多学科诊治协作共识. 中华肿瘤杂志, 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, 罗曼, 汪智峰, 等. TURBt 术前髂内动脉灌注化疗治疗 T2、T3 期肌层浸润性膀胱癌的疗效及其对患者术后生活质量的影响. 海南医学, 2017, 28(18): 2951-2955.
8.	景中民, 卢学仁, 徐海亮, 等. 单纯 TURBt 术及联合术前髂内动脉化疗栓塞术治疗肌层浸润性膀胱癌的疗效及术后并发症分析. 哈尔滨医药, 2017, 37(3): 262, 244.
9.	秦悦. 经尿道膀胱肿瘤电切术联合髂内动脉栓塞化疗治疗高龄高危浸润性膀胱癌患者的效果. 中国民康医学, 2020, 32(9): 46-48.
10.	邱腾, 胡小桃. 经尿道膀胱肿瘤切除联合栓塞化疗治疗肌层浸润性膀胱癌的临床疗效分析. 齐齐哈尔医学院学报, 2019, 40(11): 1403-1405.
11.	朱智能, 高小玲, 黄遂斌, 等. 髂内动脉化疗栓塞联合双极等离子电切术治疗大体积膀胱癌的临床应用. 介入放射学杂志, 2020, 29(6): 572-576.
12.	张国颖. 髂内动脉化疗栓塞与经尿道膀胱肿瘤电切术相结合对晚期膀胱癌的临床分析. 中外医疗, 2019, 38(6): 70-72.
13.	陈志华, 程全胜, 周荣华, 等. 髂内动脉栓塞化疗联合 TURBt 治疗因高龄高危不能耐受根治性膀胱全切的肌层浸润性膀胱癌的临床价值体会. 中国保健营养, 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.	罗健, 孙燕, 吴冠青, 等. 癌症患者生活质量调查表的编制及试测. 实用肿瘤杂志, 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, 庞然, 卢建新. 肌层浸润性膀胱癌的中西医结合保留膀胱治疗. 重庆医科大学学报, 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. 谭智勇, 付什, 栾婷, 等. 肌层浸润性膀胱癌保留膀胱综合治疗的研究进展. 中华泌尿外科杂志, 2022, 43(6): 464-468.
4. 黄健, 张旭. 中国泌尿外科和男科疾病诊断治疗指南. 北京: 科学出版社, 2022: 64.
5. 中国肿瘤医院泌尿肿瘤协作组. 中国膀胱癌保膀胱治疗多学科诊治协作共识. 中华肿瘤杂志, 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, 罗曼, 汪智峰, 等. TURBt 术前髂内动脉灌注化疗治疗 T2、T3 期肌层浸润性膀胱癌的疗效及其对患者术后生活质量的影响. 海南医学, 2017, 28(18): 2951-2955.
8. 景中民, 卢学仁, 徐海亮, 等. 单纯 TURBt 术及联合术前髂内动脉化疗栓塞术治疗肌层浸润性膀胱癌的疗效及术后并发症分析. 哈尔滨医药, 2017, 37(3): 262, 244.
9. 秦悦. 经尿道膀胱肿瘤电切术联合髂内动脉栓塞化疗治疗高龄高危浸润性膀胱癌患者的效果. 中国民康医学, 2020, 32(9): 46-48.
10. 邱腾, 胡小桃. 经尿道膀胱肿瘤切除联合栓塞化疗治疗肌层浸润性膀胱癌的临床疗效分析. 齐齐哈尔医学院学报, 2019, 40(11): 1403-1405.
11. 朱智能, 高小玲, 黄遂斌, 等. 髂内动脉化疗栓塞联合双极等离子电切术治疗大体积膀胱癌的临床应用. 介入放射学杂志, 2020, 29(6): 572-576.
12. 张国颖. 髂内动脉化疗栓塞与经尿道膀胱肿瘤电切术相结合对晚期膀胱癌的临床分析. 中外医疗, 2019, 38(6): 70-72.
13. 陈志华, 程全胜, 周荣华, 等. 髂内动脉栓塞化疗联合 TURBt 治疗因高龄高危不能耐受根治性膀胱全切的肌层浸润性膀胱癌的临床价值体会. 中国保健营养, 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. 罗健, 孙燕, 吴冠青, 等. 癌症患者生活质量调查表的编制及试测. 实用肿瘤杂志, 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, 庞然, 卢建新. 肌层浸润性膀胱癌的中西医结合保留膀胱治疗. 重庆医科大学学报, 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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