Three versus four cycles of neoadjuvant chemotherapy for muscle-invasive bladder cancer: a systematic review and meta-analysis

Figures & data

Figure 1. Flow chart of the identification and selection of the studies.

Table 1. Main characters of retrospective cohort studies included in this meta-analysis.

					Number				Age
First Author	Year	country	Race	Type	Total	3cyc	4cyc	NAC regimen	3cyc	4cyc	Stage
Ahmet Murat Aydin	2022	America	Mixed	Retrospective single center	166	107	59	GC (166)	66 (60, 73)	65 (59,71)	Stage I/II (118[71.1%]) Stage III (32[19.3%]) Stage IV (16[9.6%])
David D’Andrea	2022	Austria	Caucasian	Retrospective multicenter	828	384	444	GC (659[79.6%]); MVAC (78[9.4%]); DD-MVAC (82[9.9%]); Other (9[1.1%])	65 (58, 71)	63 (57, 70)	T2 (553[66.8%]) T3 (204[24.6%]) T4 (71[8.6%])
Hiten D. Patel	2022	America	Mixed	Retrospective multicenter	271	114	157	GC (231[85.2%]); DD-MVAC (37[13.7%]); Other (3[1.1%])	64 (56, 70)	67 (60, 72)	T2 (227[83.8%]) T3 (38[14.0%]) T4 (6[2.2%])
Karin Holmsten	2022	Sweden	Caucasian	Retrospective multicenter	706	251	455	GC (706)	67 (44, 80)	65 (34, 79)	T2 (347[49.1%]) T3 (165[23.4%]) T4 (35[5.0%]) Not assessable (159[22.5%])
Matteo Ferro	2021	Italy	Caucasian	Retrospective multicenter	219	160	59	GC (219)	66 (59, 72)	66 (60, 74)	≤T2 (132[60.3%]) ≥T3 (87[39.8%])

Table 2. The risk assessment of the included studies.  

First Author	Year	Selection				Comparability	Outcome			Total Scores
		Representative-ness of the exposed cohort	Selection of the non-exposed cohort	Ascertainment of exposure	Outcome of interest was not present at start of study	Comparability of cohorts on the basis of the design or analysis	Assessment of outcome	Follow-up long enough for outcomes to occur	Adequacy of follow up of cohorts
Ahmet Murat Aydin	2022	*	*	*	*	*	*	*	*	8
David D’. Andrea	2022	*	*	*	*	*	*	*	*	8
Hiten D. Patel	2022	*	*	*	*	*	*	*		7
Karin Holmsten	2022	*	*	*	*	*	*	*		7
Matteo Ferro	2021	*	*	*	*	*	*	*	*	8

Figure 2. (a) Forest plot of CSS (3 cycles vs 4 cycles); (b) Forest plot of OS (3 cycles vs 4 cycles); (c) Forest plot of pOR rates (3 cycles vs 4 cycles); (d) Forest plot of pCR rates (3 cycles vs 4 cycles).

Figure 3. Subgroup analysis was performed by pure UC.

Figure 4. Subgroup analysis was performed by GC regimen.

Data availability statement

All the data generated or analyzed during the current study were obtained from the included studies.