Cancer - Prostate(구연) (NP-040) 근육 침윤 및 국소 진행 방광암에서 방광 절제술 후 cisplatin을 이용한 보조 화학 요법의 역할 : 무작위 임상 시험의 체계적인 검토 및 메타 분석 ¹연세대학교 의과대학 강남세브란스병원 비뇨의학과 ²연세대학교 의과대학 세브란스병원 비뇨의학과 ³연세대학교 원주의과대학 원주세브란스기독병원 비뇨의학과 김도경¹, 이주용², 정재흥³, 하윤수¹, 구교철¹, 이광석¹, 정병하¹, 조강수¹ Background: We aimed to evaluate the effects of adjuvant chemotherapy (ACH) on survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). A subgroup analysis was also performed to examine effects in patients with locally advanced MIBC. Material and methods: A comprehensive literature search was performed in the PubMed, Embase, and Cochrane library databases for all articles published until February. The systematic review and meta-analysis was performed by pooling the randomized controlled trials (RCTs) that compared patients who received ACH after RC with those who underwent cystectomy alone. Results: Eight RCTs were selected for the analysis. These eight trials included patients with MIBC. The pooled hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were 0.61 (95% confidence interval [CI], 0.46–0.80; p = 0.0005) and 0.72 (95% CI, 0.55–0.94; p = 0.02), respectively. Four of the eight trials included patients with locally advanced MIBC (pT3-4 or pN+, or both); the pooled HRs for PFS and OS were 0.48 (95% CI, 0.39–0.60; p < 0.00001), and 0.63 (95% CI, 0.48–0.83; p = 0.0009), respectively. The absolute increases in PFS and OS for MIBC were 10% and 5%, respectively. The absolute increases in PFS and OS (17% and 10%, respectively) for locally advanced MIBC were greater compared with the absolute increases for MIBC. Conclusions: ACH following RC may improve the survival outcomes of MIBC patients. The beneficial effect of ACH might be more pronounced in patients with locally advanced MIBC. keywords : bladder cancer, chemotherapy, randomized clinical trial, meta-analysis