Efficiency And Safety Of Pirarubicin Bladder Irrigation In Prevention Of Recurrence Of Bladder Tumor: A Meta Analysis

Objective:To evaluate the effectiveness and safety of pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. Methods:MEDLINE,EMBASE, The Cochrane Library and CNKI were searched from Jan,1988 to Dec,2009. And we identified randomized controlled trials of pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. The quality of included trials was evaluated by two estimators. And meta-analysis was conducted on homogeneous studies.Results:Forteen studies (1196 patients) receive pirarubicin bladder irrigation were included. All included studies were graded in term of randomization, allocation concealment and blinding, Patients quit or lost, intent-to-treat (ITT) analysis, Group baseline. All the studies were graded B. Meta-analysis based on included studies shows that pirarubicin bladder irrigation in bladder tumor, compared with Mitomycin C, recurrence rate OR(95%CI) values were 0.44 (0.32-0.61) at the end of the second year, patients recurrence rate of the two group difference had significance statistically, p value<0.05; irritation sign of bladder OR (95%CI) values were0.96 (0.45-2.07), P>0.05at the end of the event, irritation sign of bladder of two group difference had no significance statistically, p value>0.05; hematuria OR (95%CI) values were 0.66 (0.29-1.51) at the end of the event, irritation sign of bladder of two group difference had no significance statistically, p value>0.05.Conclusions:According to our study,we advise to use pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. It has low recurrence and less side effect.Owing to high possibility of selection bias and publication bias in included studies,we expect high quality evidences provided by high quality double blind randomized control trials. Objective:To evaluate the effectiveness and safety of pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. Methods:MEDLINE, EMBASE, The Cochrane Library and CNKI were searched from Jan.1988 to Dec.2009. And we identified randomized controlled trials of pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. The quality of included trials was evaluated by two estimators. And meta-analysis was conducted on homogeneous studies.Results:Eight studies (754 patients) receive pirarubicin bladder irrigation were included. All included studies were graded in term of randomization, allocation concealment, blinding, Patients quit or lost, intent-to-treat (ITT) analysis, Group baseline. All the studies were graded C. Meta-analysis based on included studies shows that pirarubicin bladder irrigation in bladder tumor, compared with BCG, recurrence rate OR(95%CI) values were 0.78 (0.41-1.49) at the end of the first year, patients recurrence rate of the two group difference had no significance statistically, p value>0.05; recurrence rate OR(95%CI) values were 0.77 (0.44-1.33) at the end of the second year, patients recurrence rate of the two group difference had no significance statistically, p value>0.05; irritation sign of bladder OR (95%CI) values were 0.25 (0.07-0.81) at the end of the event, irritation sign of bladder of two group difference had significance statistically, p value< 0.05; hematuria OR (95%CI) values were 0.35 (0.17-0.71) at the end of the event, irritation sign of bladder of two group difference had significance statistically, p value<0.05.Conclusions:According to our study,we advise to use pirarubicin bladder irrigation in prevention of recurrence of bladder tumor. It has low recurrence and less side effect.Owing to high possibility of selection bias and publication bias in included studies,we expect high quality evidences provided by high quality double blind randomized control trials.