The Role of Adjuvant Single Postoperative Instillation of Gemcitabine for Non-Muscle-Invasive Bladder Cancer: A Systematic Review and Meta-Analysis

The Nephrotoxicity of Drugs Used in Causal Oncological Therapies

In recent years, a dynamic development of oncology has been observed, resulting from the increasingly frequent occurrence of neoplasms and therefore, increasing population of patients. The most effective form of therapy for cancer patients is complex multidisciplinary specialized disease management, including nephro-oncology care. Different forms of renal function impairment are frequently diagnosed in cancer patients. They are caused by different co-morbidities existing before starting the oncologic treatment as well as the direct undesirable effects of this therapy which may cause temporary or irreversible damage of the urinary system-especially kidneys. According to different therapeutic programs, in such cases the degree of renal damage is often crucial for the possibility of further anti-cancer treatment. Medical personnel responsible for delivering care to oncology patients should be properly educated on current methods of prevention and treatment of renal complications resulting from anti-cancer therapy. The development of oncologic medicines design, including especially immuno-oncological agents, obliges us to learn new patomechanisms determining potential adverse effects, including renal complications. This publication is focused on the most important undesirable nephrotoxic effects of the frequently used anti-cancer drugs.

Temporal Trends and Projections of Bladder Cancer Burden in China from 1990 to 2030: Findings from the Global Burden of Disease Study

PURPOSE

Identifying disease burden and risk factors of bladder cancer and projecting its epidemiological trend in China, which can provide reference data to formulate measures for its management and prevention.

METHODS

We analyzed the incidence, mortality, and disability-adjusted life-years (DALYs) data of bladder cancer in China from 1990 to 2019 and predicted to 2030 based on the Global Burden of Disease Study 2019. We also estimated the proportion of risk factors contributing to bladder cancer DALYs. The average annual percentage change (AAPC) in both sexes was calculated to quantify the temporal trends.

RESULTS

In China, the age-standardized incidence rate of bladder cancer increased from 3.3/100,000 in 1990 to 5.16/100,000 in 2019 (AAPC of 1.47), while the age-standardized mortality rate and age-standardized DALYs rate declined slightly (AAPC of -0.58 and -0.65, respectively). The burden of bladder cancer increased with age, which reached a peak over 85 years old. The main risk factor for bladder cancer was smoking, and the contribution of high fasting plasma glucose increased from 1990 to 2019, with an AAPC of 0.85 in males and 0.61 in females. We predicted total incident cases, deaths and DALYs will increase to 150,372 and 53,520 and 1043,688 in 2030, respectively. The disease burden of bladder cancer in males will consistently higher than that in females from 2020 to 2030.

CONCLUSION

Although mortality and DALYs rates showed downward trends, the disease burden remained heavy in China at present. More effective and long-term health policies are needed to develop for early prevention and treatment of bladder cancer.