Cochrane · systematic review · CD009294
Intravesical gemcitabine for non‐muscle invasive bladder cancer
Han, MA, Maisch, P, Jung, JH, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
UrologyAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
15
No studies
6
Included studies
NR
No studies 6 · 28.6%Ungraded 0 · 0%Very low 6 · 28.6%Low 9 · 42.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Gemcitabine compared to saline
Population: participants with non‐muscle invasive bladder cancer (607 men, 127 women)Country: Germany, Turkey, and the US
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to recurrence (absolute effect size estimates based on recurrence rate at 4 years) Gemcitabine vs saline | HR 0.77 [0.54, 1.09] | 2 studies · 734 participants | Low Downgraded: risk of bias |
Time to progression (absolute effect size estimates based on progression rate at 4 years) Gemcitabine vs saline | HR 0.96 [0.19, 4.71] | 2 studies · 654 participants | Low Downgraded: risk of bias |
Grade III–V adverse events Gemcitabine vs saline | RR 1.26 [0.58, 2.75] | 2 studies · 668 participants | Low Downgraded: risk of bias |
Time to death from bladder cancer(absolute effect size estimates based on death rate at 2 years) Gemcitabine vs saline | HR 0.98 [0.02, 49.4] | 1 study · 328 participants | Very low Downgraded: risk of bias |
Time to death from any cause (absolute effect size estimates based on death rate at 4 years) Gemcitabine vs saline | HR 0.62 [0.39, 1] | 2 studies · 734 participants | Very low Downgraded: risk of bias |
Grade I or II adverse events Gemcitabine vs saline | RR 1.13 [0.87, 1.45] | 2 studies · 668 participants | Low Downgraded: risk of bias |
Disease‐specific quality of life Gemcitabine vs saline | no estimate extracted | NR | No studies |
Gemcitabine compared to mitomycin
Population: participants with non‐muscle invasive bladder cancer1 (93 men, 16 women)Country: Italy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to recurrence Gemcitabine vs mitomycin | HR 0.36 [0.19, 0.69] | 1 study · 109 participants | Low Downgraded: risk of bias, imprecision |
Time to progression Gemcitabine vs mitomycin | HR 0.57 [0.32, 1.01] | 1 study · 109 participants | Low Downgraded: risk of bias, imprecision |
Grade III–V adverse events (local adverse events which result in delay intravesical treatment were regarded as Grade III–V complications) Gemcitabine vs mitomycin | RR 0.51 [0.13, 1.93] | 1 study · 109 participants | Very low Downgraded: risk of bias, imprecision |
Time to death from bladder cancer Gemcitabine vs mitomycin | no estimate extracted | NR | No studies |
Time to death from any cause Gemcitabine vs mitomycin | no estimate extracted | NR | No studies |
Grade I or II adverse events (local adverse events which did not result in delay intravesical treatment) Gemcitabine vs mitomycin | RR 0.53 [0.37, 0.78] | 1 study · 109 participants | Low Downgraded: risk of bias, imprecision |
Disease‐specific quality of life Gemcitabine vs mitomycin | no estimate extracted | NR | No studies |
Gemcitabine compared to BCG for recurrent (one‐course BCG failure) non‐muscle invasive bladder cancer
Population: participants with recurrent (1‐course BCG failure) high‐risk non‐muscle invasive bladder cancer (49 men, 31 women)Country: Italy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Time to recurrence Gemcitabine vs BCG | HR 0.15 [0.09, 0.26] | 1 study · 80 participants | Low Downgraded: risk of bias |
Time to progression Gemcitabine vs BCG | HR 0.45 [0.27, 0.76] | 1 study · 80 participants | Low Downgraded: risk of bias |
Grade III–V adverse events Gemcitabine vs BCG | RR 1 [0.21, 4.66] | 1 study · 80 participants | Very low Downgraded: risk of bias |
Time to death from bladder cancer Gemcitabine vs BCG | HR 0.04 [0.01, 2.25] | 1 study · 80 participants | Very low Downgraded: risk of bias |
Time to death from any cause Gemcitabine vs BCG | no estimate extracted | NR | No studies |
Grade I or II adverse events Gemcitabine vs BCG | RR 0.92 [0.48, 1.77] | 1 study · 80 participants | Very low Downgraded: risk of bias |
Disease‐specific quality of life Gemcitabine vs BCG | no estimate extracted | NR | No studies |