A Meta-analysis Of BCG For Prevention Of Postoperative Recurrence Of Superficial Bladder Cancer

Objective:â‘ To assess the efficacy and side effects of intravesically administered BCG following TURB-t in patients with superficial bladder cancer compared to TURB-t alone;â‘¡To assess the efficacy and side effects of intravesically administered BCG following TURB-t in patients with superficial bladder cancer compared to intravesically administered MMC;â‘¢To assess the efficacy and side effects of intravesically administered standard-dose BCG following TURB-t in patients with superficial bladder cancer compared to intravesically administered low-dose BCG..Methods: Searches were applied to the following electronic database: Medline;CNKI;(1980.1-2006.6);EmbaseDatabase;CochraneLiberary.Meanwhile,handsearch was applied in recent Chin J Urol and other three Journal. Randomized controlled trial should be used without limiting language or only used blinding participant. Data were extracted independently by two reviewer. The methodological quality of trails was assessed by the Jadad-Score. Statistical analysis were performed with Ravman4.2.Result: At first 28 Chinese papers and 138 foreign papers were found ,there are 16 papers fitting for the systematic review, all of them are foreign papers. There are 16 RCTs which have 3252 patients were eligible according to the including criterion., all these were divided into three groups, group 1(TURB-t+BCG / TURB-t alone)includes 6 RCTs which have 675 patients and group 2(TURB-t+BCG / TURB-t+MMC)includes 7 RCTs which have 1852 patients and group 3(TURB-t+ standard-dose BCG / TURB-t + low-dose BCG)includes3 RCTs which have 725 patients .Meta-analysis of group 1 showed that intravesically administered BCG following TURB-t in patients with superficial bladder cancer had more benefit in reduing the incidence of tumor recurrence than TURB-t alone;Meta-analysis of group 2 showed that intravesically administered BCG following TURB-t in patients with superficial bladder cancer had more benefit in reduing the incidence of tumor recurrence than intravesically administered MMC, however, in morbility of cystitis BCG is moer than MMC. Meta-analysis of group 3 showed that intravesically administered standard-dose BCG following TURB-t in patients with superficial bladder cancer had no more benefit in reduing the incidence of tumor recurrence than intravesically administered low-dose BCG."Funnel plot"show imsymmetry which relate to less quality in methology and small in sampleConclusion: Intravesically administered BCG following TURB-t in patients with superficial bladder cancer had benefit in reduing the incidence of tumor recurrence .Most of urologists agreed that MMC was the best intravesical chemotherapy. However, Intravesically administered MMC following TURB-t in patients with superficial bladder cancer had more benefit in reduing the incidence of tumor recurrence than intravesically administered BCG.. Intravesically administered standard-dose BCG following TURB-t in patients with superficial bladder cancer had no more benefit in reduing the incidence of tumor recurrence than intravesically administered low-dose BCG. And as reduing the dose of BCG, side effects of BCG became small. Because the research design, effective target which have been integrated this system appraisal existence differences and so on standard, literature quantity are few, possibly to a certain extent affects the test result. Due to the low quanity of method and the power of evidence was low. So large sample RCTs with multiply-center should be carried out assess the effect.