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World J Urol. 2009 Jun;27(3):319-24. doi: 10.1007/s00345-009-0384-2. Epub 2009 Feb 22.

Intravesical hyperthermia and mitomycin-C for carcinoma in situ of the urinary bladder: experience of the European Synergo working party.

Author information

1
Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, Nijmegen 6500 HB, The Netherlands. f.witjes@uro.umcn.nl

Abstract

OBJECTIVES:

To study the results of chemotherapy combined with intravesical hyperthermia in patients with mainly BCG-failing carcinoma in situ (CIS).

METHODS:

Patients with histologically confirmed CIS were included retrospectively. Outpatient thermochemotherapy treatment was done with mitomycin-C (MMC) and the Synergo system SB-TS 101 (temperature range between 41 and 44 degrees C), weekly for 6-8 weeks, followed by 4-6 sessions every 6-8 weeks.

RESULTS:

Fifty-one patients were treated between 1997 and 2005 from 15 European centers. Thirty-four were pre-treated with BCG. Mean age was 69.9 years. Twenty-four patients had concomitant papillary tumors. The mean number of hyperthermia/MMC treatments per patient was 10.0. Of the 49 evaluable patients 45 had a biopsy and cytology proven complete response. In two patients CIS disappeared, but they had persistent papillary tumors. Follow-up of 45 complete responders showed 22 recurrences after a mean of 27 months (median 22): T2 (4), T1 (4), T1/CIS (1), CIS (5), Ta/CIS (2), Ta (5) and Tx (1). Side effects (bladder complaints) were generally mild and transient.

CONCLUSIONS:

In patients with primary or BCG-failing CIS, treatment with intravesical hyperthermia and MMC appears a safe and effective treatment. The initial complete response rate is 92%, which remains approximately 50% after 2 years.

PMID:
19234857
PMCID:
PMC2694311
DOI:
10.1007/s00345-009-0384-2
[Indexed for MEDLINE]
Free PMC Article

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