Application of principles of evidence-based medicine in cancer of the urinary bladder


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Resumo

Meta-analysis has been made to answer the question whether a proven
advantage exists of chemotherapy of locally advanced and metastatic
cancer of the urinary bladder (UB) with gemcitabine+cisplatin over the
scheme M-VAC. The data for 1990-2002 obtained from the data base
Medline, library of Cocrane Association, proceedings of the symposia
and conferences, publications in domestic periodicals Urologiya, Voprosy
Onkologii covered 3477 items on UB cancer.Nine publications
were selected which seem to use significant information in terms of evidence-based
medicine. The patients were divided into two groups.
Group 1 consisted of patients with local and metastatic UB cancer treated
with the combination gemcitabine+cisplatin (n = 390). Group 2 patients (n = 499)
received chemotherapy with M-VAC. By principles of
evidence-based medicine, group 1 patients had more frequent unfavourable
outcomes (absence of complete and partial regressions) - 50 and
42%, respectively. A decrease in the absolute risk is significant (p < 0.05,
chisquare = 5.8). It is 8% in the confidence interval (CI) 4,12. A decrease
in the relative risk was 19% (CI 13.7-24.3), odds ratio 1.39 in CI
1.3-1.48. Thus, at present there are no reliable data on advantages of local
and metastatic UB cancer treatment with the scheme gemcitabine-cysplatin
over standard treatment M-VAC

Sobre autores

О Apolikhin

I Chernyshev

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