Clinical complete response as a surrogate for pathological response in bladder cancer: a systematic review and meta-analysis - PubMed
5 hours ago
- #meta-analysis
- #clinical complete response
- #bladder cancer
- Evaluates concordance between clinical complete response (cCR) and pathological complete response (pCR) in muscle-invasive bladder cancer (MIBC).
- Systematic review and meta-analysis of 13 studies (n=1075) with varied restaging modalities for cCR assessment.
- Pooled concordance between cCR and pCR was 0.51 (95% CI 0.42-0.60), and between non-cCR and non-pCR was 0.84 (95% CI 0.70-0.92).
- Most studies had moderate bias concerns; one had serious bias due to examiner-dependent cystoscopy-based cCR assessment.
- Current evidence does not support relying solely on cCR to guide treatment decisions due to poor prediction of pCR.
- Ongoing trials may refine cCR evaluation using MRI plus TURB with circulating tumor DNA for bladder-sparing strategies.