{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:06:20Z","timestamp":1790071580953,"version":"4.0.1"},"reference-count":126,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Non-muscle-invasive bladder cancer (NMIBC) is characterized by frequent recurrence and prolonged surveillance. Traditional Chinese medicine (TCM) has been investigated as an adjunct to standard NMIBC management, but its syndrome characteristics and pharmacological evidence remain heterogeneous. This review combined a scoping review of TCM syndrome-related evidence with a critical narrative synthesis of pharmacological and mechanistic studies. The scoping review included 59 sources and identified 155 syndrome-element occurrences. Deficiency (23.9%), dampness (21.3%), heat (20.6%), stasis (16.8%), and toxin (14.8%) were most frequently reported. Among 59 composite-pattern occurrences, Dampness\u2013Heat (30.5%) and Stasis\u2013Toxin (18.6%) predominated. These results reflect literature-level reporting patterns rather than patient-level prevalence. Mechanistic evidence involved tumor-cell survival and death, inflammatory and immune regulation, angiogenesis, invasion, migration, extracellular-matrix remodeling, and tumor-cell reimplantation. However, much of this evidence derives from broader bladder cancer experimental models or predictive analyses, and direct evidence for reducing NMIBC recurrence or progression remains limited. Overall, TCM syndrome characteristics in NMIBC can be described systematically, but mechanistic findings should be interpreted according to their disease context and evidence relevance. Future studies should emphasize standardized syndrome reporting, reproducible intervention characterization, NMIBC-relevant models, and clinically meaningful recurrence-related outcomes.<\/jats:p>","DOI":"10.3389\/fphar.2026.1921622","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:35:40Z","timestamp":1790069740000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Traditional Chinese medicine in non-muscle-invasive bladder cancer: a scoping review of syndrome characteristics and critical synthesis of pharmacological and mechanistic evidence"],"prefix":"10.3389","volume":"17","author":[{"given":"Xi-Zhe","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]},{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology","place":["Macao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiong-Ao","family":"Xiang","sequence":"additional","affiliation":[{"name":"Beijing Friendship Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-chang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]},{"name":"Faculty of Chinese Medicine, Macau University of Science and Technology","place":["Macao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Dong","family":"Li","sequence":"additional","affiliation":[{"name":"Medical Affairs Department, The Fourth People\u2019s Hospital of Shunde, Foshan (Wu Zhongpei Memorial Hospital of Shunde, Foshan)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3389\/fonc.2020.00175","article-title":"Modifying the non-muscle invasive bladder cancer immune microenvironment for optimal therapeutic response","volume":"10","author":"Annels","year":"2020","journal-title":"Front. 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