Sternberg Cora N, Calabró Fabio
Department of Medical Oncology, San Camillo and Forlanini Hospitals, Nuovi Padiglioni IV Floor, Circonvallazione Gianicolense 87, 00152 Rome, Italy.
Expert Rev Anticancer Ther. 2005 Dec;5(6):987-92. doi: 10.1586/14737140.5.6.987.
Radical cystectomy is a standard treatment for patients with muscle-invasive bladder cancer. The presence of occult micrometastatic disease is responsible for both local and distant failure after radical surgery. Postoperative administration of chemotherapy in bladder cancer patients can theoretically give the same survival advantage demonstrated in patients with breast and colon cancer. Studies evaluating adjuvant chemotherapy in patients with pT3-pT4 and/or pN+ M0 disease have major deficiencies in terms of sample sizes, early stopping of patient entry, statistical analyses, reporting of results and drawing conclusions. A recent meta-analysis including all previously published randomized trials concludes that, currently, there is insufficient evidence to reliably recommend adjuvant chemotherapy. The results of appropriately sized randomized trials are needed before any definitive conclusions can be drawn.
根治性膀胱切除术是肌层浸润性膀胱癌患者的标准治疗方法。隐匿性微转移疾病的存在是根治性手术后局部和远处失败的原因。理论上，膀胱癌患者术后给予化疗可带来与乳腺癌和结肠癌患者相同的生存优势。评估pT3 - pT4和/或pN + M0疾病患者辅助化疗的研究在样本量、患者入组提前终止、统计分析、结果报告和结论得出方面存在重大缺陷。最近一项纳入所有先前发表的随机试验的荟萃分析得出结论，目前，没有足够的证据可靠地推荐辅助化疗。在得出任何明确结论之前，需要适当规模随机试验的结果。
