Actas urologicas espanolas · 2026
Efficacy and safety of active surveillance and chemoablation in the management of non-muscle invasive bladder cancer (NMIBC): Systematic review and pooled analysis by the European Association of Urology-Young Academic Urologists: Urothelial Carcinoma Working Group.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
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Saouli A, Contieri R, Quhal F, Hurle R, Guenouni M, Ploussard G, Mori K, Yanagisawa T, Pradere B, Laukhtina E, Rajwa P, Albisinni S, Krajewski W, Cimadamore A, Del Giudice F, Gómez Rivas J, Soria F, Shariat S F, Gontero P, Mertens L S, van Rhijn B W G, AlShammari M, Gallioli A, Moschini M
Аннотация
OBJECTIVE: To evaluate the oncological outcomes and safety of chemoablation and Active Surveillance for non-muscle invasive bladder cancer.
METHODS: A systematic review was performed by accessing the following bibliographic databases: PubMed, Scopus, Embase and the Cochrane central register of controlled trials were searched.
RESULTS: A total of 29 studies (1847 patients) met the inclusion criteria. The vast majority of patients included had Active Surveillance (n = 7, 582) and chemoablation (n = 21, 1265). Regarding chemoablation, Mitomycine C (MMC) was used in 14 studies, Epirubicin in 2 studies, Bacillus Calmette-Guerin (BCG) in one study and Gemcitabine in 5 studies (weekly or single dose). Follow-up ranged from 2 weeks to 39 months (Mean 16.8 months). The mean timing of initial assessment was 4.2 (range: 1 day to 27 weeks), and the pooled complete response (CR) rate was 52.3%. For the AS protocol, the pathological findings before observation were Ta (n = 583, 86%), low (n = 462, 60.1%) and high grade (n = 138, 42.1%). Mean follow up was 47 months ranged from 25 to 72 months, the mean duration of AS was 13.4 months. The mean AS failure rate was 64%. Grade progression, stage progression and progression to muscle-invasive bladder cancer (MIBC) were 68 (16.5%), 35 (8.5%) and 5 (1%) of cases, respectively.
CONCLUSIONS: Patients with selected inclusion criteria based on the review can be referred for active Surveillance or chemoablation protocol, with a minimal risk of progression in either grade or stage for AS and a good complete response for chemoablation.
METHODS: A systematic review was performed by accessing the following bibliographic databases: PubMed, Scopus, Embase and the Cochrane central register of controlled trials were searched.
RESULTS: A total of 29 studies (1847 patients) met the inclusion criteria. The vast majority of patients included had Active Surveillance (n = 7, 582) and chemoablation (n = 21, 1265). Regarding chemoablation, Mitomycine C (MMC) was used in 14 studies, Epirubicin in 2 studies, Bacillus Calmette-Guerin (BCG) in one study and Gemcitabine in 5 studies (weekly or single dose). Follow-up ranged from 2 weeks to 39 months (Mean 16.8 months). The mean timing of initial assessment was 4.2 (range: 1 day to 27 weeks), and the pooled complete response (CR) rate was 52.3%. For the AS protocol, the pathological findings before observation were Ta (n = 583, 86%), low (n = 462, 60.1%) and high grade (n = 138, 42.1%). Mean follow up was 47 months ranged from 25 to 72 months, the mean duration of AS was 13.4 months. The mean AS failure rate was 64%. Grade progression, stage progression and progression to muscle-invasive bladder cancer (MIBC) were 68 (16.5%), 35 (8.5%) and 5 (1%) of cases, respectively.
CONCLUSIONS: Patients with selected inclusion criteria based on the review can be referred for active Surveillance or chemoablation protocol, with a minimal risk of progression in either grade or stage for AS and a good complete response for chemoablation.