非那雄胺对调节膀胱癌风险及临床结局的影响：一项全面荟萃分析的见解
Impact of finasteride on modulating the risk and clinical outcomes of bladder cancer: insights from a comprehensive meta-analysis.
作者信息
Yu Ailing, Bai Zian, Wang Yijie, Luo Zhen, Du Xiaochen, Chen Mengxin, Wen Shuang, Wang Honglong, Yuan Xiaoying, Yang Chunyu, Bai Shanshan, Fan Bo
机构信息
Department of Urology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Liaoning Provincial Key Laboratory of Urological Digital Precision Diagnosis and Treatment, Dalian, Liaoning, China.
出版信息
Front Pharmacol. 2025 Jan 29;16:1471442. doi: 10.3389/fphar.2025.1471442. eCollection 2025.
PURPOSE
Numerous prior analyses have highlighted a potential link between androgen suppression therapy (AST) and bladder cancer (BCa). However, there is a notable gap in research specifically examining the influence of finasteride on BCa risk and clinical outcomes. This study aimed to evaluate preventive and therapeutic value of finasteride for BCa patients.
METHODS
This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. The PubMed, Embase, Cochrane Library, and Web of Science databases were searched up to 20 December 2024, to identify studies that examined the intake of finasteride and its impact on the incidence and clinical prognosis of patients with BCa. Data was extracted for further analysis by two different reviewers who independently examined the titles and abstracts of the included articles. Subgroup analyses and leave-one-out sensitivity analyses, were applied to mitigate the potential confounding factors associated with heterogeneity.
RESULTS
Our investigation revealed that finasteride markedly decreased the likelihood of developing BCa (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.63-0.88). Subgroup analyses indicated that the preventive effect of finasteride in BCa incidence were generally consistent, regardless of study region, types of research. Furthermore, no notable disparities were observed in OS, CSS, or RFS between the finasteride group and the control group.
CONCLUSION
Finasteride plays a protective role against the progression of BCa, nevertheless, its effects on prognostic outcomes, including OS, CSS, and RFS, remain inconclusive. Additional multi-center prospective studies with long-term follow-up are required to further validate prophylactic role of finasteride on bladder cancer.
SYSTEMATIC REVIEW REGISTRATION NUMBER
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=525046, identifier CRD42024525046.
目的
此前众多分析强调了雄激素抑制疗法（AST）与膀胱癌（BCa）之间的潜在联系。然而，在专门研究非那雄胺对BCa风险和临床结局影响的研究方面存在显著差距。本研究旨在评估非那雄胺对BCa患者的预防和治疗价值。
方法
本荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。截至2024年12月20日，对PubMed、Embase、Cochrane图书馆和科学网数据库进行了检索，以识别研究非那雄胺摄入量及其对BCa患者发病率和临床预后影响的研究。由两名不同的审阅者提取数据进行进一步分析，他们独立检查纳入文章的标题和摘要。应用亚组分析和逐一剔除敏感性分析来减轻与异质性相关的潜在混杂因素。
结果
我们的调查显示，非那雄胺显著降低了患BCa的可能性（风险比[HR]：0.75，95%置信区间[CI]：0.63 - 0.88）。亚组分析表明，无论研究地区、研究类型如何，非那雄胺对BCa发病率的预防作用总体一致。此外，非那雄胺组与对照组在总生存期（OS）、癌症特异性生存期（CSS）或无复发生存期（RFS）方面未观察到显著差异。
结论
非那雄胺对BCa的进展起到保护作用，然而，其对包括OS、CSS和RFS在内的预后结局的影响仍无定论。需要更多长期随访的多中心前瞻性研究来进一步验证非那雄胺对膀胱癌的预防作用。
系统评价注册号
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=525046，标识符CRD42024525046。
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