Postoperative Adjuvant Iliac Artery Perfusion Chemotherapy For The Treatment Of High-risk Non-muscular Invasion Efficacy Of Bladder Cancer:A Meta-analysis

Objective:Systematically evaluate the efficacy of transurethral resection of bladder cancer combined with bladder perfusion therapy combined with iliac artery infusion chemotherapy(experiment al group)and transurethral resection of bladder cancer combined with bladder perfusion thera py(control group)in high-risk non-muscle invasive bladder cancer.Methods:Search Pub Med,Cochrane library,Embase,Web of science,Chinese journal full-text dat abase(CNKI),Wanfang database,Vip database,and Chinese biomedical literature database(CBM)by computer.The search time is from the establishment of the database to July 2022.Two researchers independently screened the literature,extracted data,evaluated the quality a nd cross-checked.Use the Review Manager5.4 software provided by Cochrane collaboration network to conduct meta-analysis,and select the appropriate effect value according to the typ e of study and efficacy indicators finally included,P<0.05 is statistically significant.Results:A total of 5 articles were included,including 1 Chinese literature and 4 English literatu re.Two were case-control studies and three were randomised controlled studies.A total of 818 cases were included in the study subjects,338 cases in the experimental group and 480 cases in the control group.The results of meta-analysis showed that the recurrence rate after combination was 0.35,95% CI(0.17,0.72),P=0.005,the difference was statistically signific ant,indicating that postoperative adjuvant iliac artery perfusion chemotherapy could reduce th e risk of tumor recurrence.The combined progression rate was 0.52,95% CI(0.36,0.75),P=0.0005,the difference was statistically significant,indicating that postoperative adjuvant iliac artery perfusion chemotherapy could reduce the risk of tumor progression.In terms of overall survival and tumor-specific mortality,the combined OR values were 1.78,95% CI(1.08,2.94),P=0.02,OR=0.49,95% CI(0.27,0.88),P=0.02,respectively,and the differences were st atistically significant.The results showed that postoperative supplementation with iliac artery p erfusion chemotherapy could improve overall survival and reduce tumor-specific mortality,and in sensitivity analysis,it was found that the forest plot intersected with the ineffective line,i ndicating that the combined results were unstable.Conclusion:Patients with high-risk non-muscle-invasive bladder cancer combined with intravesthral bl adder tumor resection combined with bladder infusion therapy followed by iliac artery perfusi on chemotherapy can better prevent tumor recurrence and progression,improve overall surviv al and reduce tumor-specific mortality.In addition,adjuvant iliac artery perfusion chemotherap y is more reliable than evidence that improves overall survival and reduces tumor-specific m ortality in reducing tumor recurrence and progression.For patients with high-risk non-muscle-i nvasive bladder cancer,postoperative adjuvant iliac artery perfusion chemotherapy is a safe,f easible,and effective treatment when choosing a bladder-sparing regimen.But thanks to this research There are some unavoidable limitations,so more high-quality,large-sample randomiz ed controlled studies are needed to further confirm this study.