학술논문

Clinical significance of 5-α reductase inhibitor and androgen deprivation therapy in bladder cancer incidence, recurrence, and survival: a meta-analysis and systemic review.
Document Type
Journal Article
Source
Aging Male. Dec2020, Vol. 23 Issue 5, p971-978. 8p.
Subject
*BLADDER cancer
*ANDROGEN deprivation therapy
*CANCER treatment
*REDUCTASE inhibitors
*CANCER relapse
*RESEARCH
*ANTIANDROGENS
*META-analysis
*ANDROGENS
*RESEARCH methodology
*SYSTEMATIC reviews
*DISEASE incidence
*MEDICAL cooperation
*EVALUATION research
*COMPARATIVE studies
*PROSTATE tumors
*ENZYME inhibitors
BLADDER tumors
Language
ISSN
1368-5538
Abstract
Purpose: This study aimed to investigate the effect of androgen suppression therapy (AST), comprising a 5-α reductase inhibitor (5-ARi) and androgen deprivation therapy (ADT), on the risk of bladder cancer incidence, recurrence, and mortality.Materials and Methods: We used the PRISMA statement to report the methods and results of this meta-analysis. Bladder cancer incidence, recurrence, and mortality after 5-ARi treatment and ADT were assessed using risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs). The protocol of this study is registered in the PROSPERO database (No. CRD42018118627).Results: We analyzed nine studies (n = 377,427) assessing the secondary effect of AST, with a mean follow-up period of 6 years (range, 2-13 years). Our result showed that the incidence of bladder cancer was significantly reduced when 5-ARi treatment (RR, 0.69; 95% CI, 0.58-0.81; I2 =0%) and ADT (HR, 0.81; 95% CI, 0.70-0.94; I2 =33%) were initiated before diagnosing bladder cancer. When treatment was initiated after diagnosing bladder cancer, 5-ARi treatment reduced cancer-specific mortality (RR, 0.29; 95% CI, 0.20-0.42; I2 =4.1%), whereas ADT reduced bladder cancer recurrence (HR, 0.30; 95% CI, 0.19-0.49; I2 =0%).Conclusions: This study corroborates that the use of 5-ARi and ADT could be helpful in managing bladder cancer and should not be limited to prostatic abnormalities. [ABSTRACT FROM AUTHOR]