Bladder cancer: (2022) Adjuvant chemotherapy, systematic review and IPD meta-analysis
Adjuvant Chemotherapy for Muscle-invasive Bladder Cancer: A Systematic Review and Meta-analysis of Individual Participant Data from Randomised Controlled Trials
Does chemotherapy after surgery offer an advantage over surgery alone for those diagnosed with for muscle-invasive bladder cancer?
What was this study about?
Until now, the effects of giving chemotherapy after surgery people with bladder cancer that has spread to the surrounding muscle were not clear. Our prior systematic review and meta-analysis based on individual participant data (IPD) from randomised trials, was limited by the number and size of the included trials. The results have been updated with data from 1183 participants from 10 trials. This is more than double the number of participants previously included.
What difference did this study make?
This IPD meta-analysis showed clear evidence that chemotherapy after surgery offers an advantage over surgery alone for those diagnosed with muscle-invasive bladder cancer. It shows that 56 out of 100 participants who received chemotherapy before surgery were alive at 5 years compared to 50 out of 100 who received surgery alone. These benefits were apparent irrespective of age of the participants, tumour stage or the type of chemotherapy. Also, more people were alive without disease recurrence at 5 years (63 out of 100 compared to 50 out of 100).
Advanced Bladder Cancer (ABC) Collaborators Group. Adjuvant chemotherapy for muscle-invasive bladder cancer: A systematic review and meta-analysis of individual participant data from randomised controlled trials. European Urology. 2022; 81(1): 50-61
Type of study
Who funded the study?
Medical Research Council, UK
When did it take place?
This study was fully published in 2022 and brought together the results of trials that were carried out between 1980 and 2014.
Where did it take place?
This study was done at the MRC Clinical Trials Unit at UCL but brings together the results of trials from all over the world.
Who was included?
This study brought together 10 trials (1183 patients) that studied the addition of chemotherapy after surgery versus surgery alone, in those diagnosed with muscle-invasive bladder cancer.