Adjuvant chemotherapy for invasive bladder cancer appears to improve survival.
A Cochrane review 1 included 6 studies with a total of 491 subjects. The overall hazard ratio for survival was 0.75 (95% CI 0.60 to 0.96, p=0.019), suggesting a 25% relative reduction in the risk of death for chemotherapy compared to that on control. The impact of trials that stopped early, of patients not receiving allocated treatments or not receiving salvage chemotherapy is unclear. The power of the meta-analysis is clearly limited.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).
1. Advanced Bladder Cancer (ABC) Meta-analysis Collaboration. Adjuvant chemotherapy for invasive bladder cancer (individual patient data). Cochrane Database Syst Rev 2006 Apr 19;(2):CD006018. [PMID:16625650]
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"Adjuvant Chemotherapy for Invasive Bladder Cancer." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer.
Adjuvant chemotherapy for invasive bladder cancer. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer. Accessed July 8, 2020.
Adjuvant chemotherapy for invasive bladder cancer. (2019). In Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited. Retrieved July 08, 2020, from https://evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer
Adjuvant Chemotherapy for Invasive Bladder Cancer [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2020 July 08]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer.
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