Level of Evidence = B
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
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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 August 21, 2019.
Adjuvant chemotherapy for invasive bladder cancer. (2019). In Evidence-Based Medicine Guidelines. Available 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 2019 August 21]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer.
TY - ELEC
T1 - Adjuvant chemotherapy for invasive bladder cancer
ID - 456580
BT - Evidence-Based Medicine Guidelines
UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/456580/all/Adjuvant_chemotherapy_for_invasive_bladder_cancer
PB - Duodecim Medical Publications Limited
DB - Evidence Central
DP - Unbound Medicine