Supplementary Material for: Gender-specific differences in recurrence and progression following BCG instillation for NMIBC

Introduction: To assess gender-specific differences in recurrence-free (RFS), progression-free (PFS), cancer-specific survival (CSS) and overall survival (OS) among patients with intermediate or high-risk non-muscle invasive bladder cancer (NMIBC) receiving BCG is the primary aim of this systematic review and meta-analysis.
Methods: In July 2023, we performed a literature search using MEDLINE, Embase and Cochrane Library. This study was prospectively registered at PROSPERO (CRD 2023443269). The detailed review protocol is accessible via CRD.
Results: The systematic literature search identified 6,723 studies, of which 38 fulfilled the inclusion criteria. Random effect meta-analysis for RFS, based on data from 24 studies, revealed no statistically significant gender-specific difference (HR comparing males to females=0.9618, 95% CI: 0.8408-1.1003, p=0.5707). Similarly, for PFS, incorporating data from 14 studies, no statistically significant difference (HR =0.9540, 95% CI: 0.7709- 1.1805, p=0.6648), for CSS, analysis of data from three studies yielded no statistically significant difference (HR =0.9228, 95% CI: 0.6196-1.3743, p=0.6925), and for OS, based on data from two studies, no statistically significant difference was observed (HR = 1.1436, 95% CI: 0.5092-2.5684, p=0.7452). The risk of bias assessment indicated an overall moderate to high risk of bias.
Conclusion: The findings indicate no association between gender and oncologic outcomes following BCG.

引言：本系统综述与荟萃分析的主要目的是评估接受卡介苗（BCG）治疗的中高危非肌层浸润性膀胱癌（non-muscle invasive bladder cancer, NMIBC）患者在无复发生存期（recurrence-free survival, RFS）、无进展生存期（progression-free survival, PFS）、癌症特异性生存期（cancer-specific survival, CSS）及总生存期（overall survival, OS）方面的性别特异性差异。

方法：2023年7月，我们利用MEDLINE、Embase及Cochrane Library数据库进行文献检索。本研究已在PROSPERO前瞻性注册（注册号：CRD 2023443269），详细综述方案可通过CRD获取。

结果：系统文献检索共识别出6723项研究，其中38项符合纳入标准。基于24项研究数据的RFS随机效应荟萃分析显示，性别特异性差异无统计学意义（男性与女性的风险比（hazard ratio, HR）=0.9618，95%置信区间（confidence interval, CI）：0.8408-1.1003，p=0.5707）。同理，纳入14项研究数据的PFS分析亦无统计学显著差异（HR=0.9540，95%CI：0.7709-1.1805，p=0.6648）；基于3项研究数据的CSS分析未发现统计学显著差异（HR=0.9228，95%CI：0.6196-1.3743，p=0.6925）；而基于2项研究数据的OS分析同样未见统计学显著差异（HR=1.1436，95%CI：0.5092-2.5684，p=0.7452）。偏倚风险评估显示，总体偏倚风险为中度至高度。

结论：研究结果表明，性别与卡介苗（BCG）治疗后的肿瘤学结局之间无关联。