Carr L K, Klotz L H
Department of Surgery, Division of Urology, University of Toronto.
Can J Urol. 1994 Nov;1(4):83-6.
We examined randomized controlled trials in urologic oncology published in 1992. Particular emphasis was placed on the contribution of urologists and studies with a surgical arm. Randomized controlled trials in bladder, prostate, testis and renal carcinoma were identified by a structured MEDLINE search. Results were analyzed to determine modality of treatment, disease site, principal author, country of origin, cohort size, number of participating centers, source of funding and type of journal. MEDLINE retrieved 162 references of which 126 were excluded by title (10), abstracts (105) or articles (11) as not urologic oncology (7) or not a randomized controlled trials (119). Of the qualifying 36 randomized controlled trials, the site of the disease was bladder (44%), prostate (39%) renal (14%) and testis (3%). All except six randomized controlled trials compared medical therapies. Only five had a surgical arm and one had a radiation arm. Cohort size was > 100 in 67% of randomized controlled trials with most (56%) being multicenter trials. Participating countries were Europe, excluding the UK (35%), the US (23%), Japan (20%), Canada (13%), and the UK (10%). Urologists were the principal authors of 67% of the papers describing randomized controlled trials. The majority of trials were published in nonsurgical journals (50%). Funding for randomized controlled trials was from government (28%), pharmaceutical companies (19%), private sources (3%) and not stated (50%). Although randomized controlled trials are being conducted in urologic oncology, there are relatively few compared with trials using inferior study designs. A still smaller proportion of randomized controlled trials contain a surgical arm.
我们检索了1992年发表的泌尿外科肿瘤学领域的随机对照试验。特别强调了泌尿外科医生的贡献以及包含手术治疗组的研究。通过结构化的医学文献数据库（MEDLINE）检索膀胱、前列腺、睾丸和肾癌的随机对照试验。对结果进行分析，以确定治疗方式、疾病部位、主要作者、原产国、队列规模、参与中心数量、资金来源和期刊类型。MEDLINE检索到162篇参考文献，其中126篇因标题（10篇）、摘要（105篇）或文章内容（11篇）被排除，原因是不属于泌尿外科肿瘤学范畴（7篇）或不是随机对照试验（119篇）。在符合要求的36项随机对照试验中，疾病部位为膀胱（44%）、前列腺（39%）、肾脏（14%）和睾丸（3%）。除6项随机对照试验外，其他所有试验均比较了药物治疗。只有5项试验设有手术治疗组，1项试验设有放射治疗组。67%的随机对照试验队列规模大于100，其中大多数（56%）为多中心试验。参与的国家有欧洲（不包括英国，占35%）、美国（23%）、日本（20%）、加拿大（13%）和英国（10%）。67%描述随机对照试验的论文的主要作者是泌尿外科医生。大多数试验发表在非外科领域的期刊上（50%）。随机对照试验的资金来源为政府（28%）、制药公司（19%）、私人来源（3%），未说明资金来源的占50%。尽管泌尿外科肿瘤学领域正在开展随机对照试验，但与采用质量较差研究设计的试验相比数量相对较少。包含手术治疗组的随机对照试验所占比例更小。
