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Urol Int. 2012;89(3):311-8. doi: 10.1159/000341912. Epub 2012 Sep 7.

Thermochemotherapy for non-muscle-invasive bladder cancer: is there a chance to avoid early cystectomy?.

Author information

1
Department of Urology, Catholic University of the Sacred Heart, Rome, Italy. dr.avolpe@gmail.com

Abstract

OBJECTIVES:

Non-muscle-invasive bladder cancer is characterized by a high recurrence rate after primary transurethral resection. In case of bacillus Calmette-Guérin-refractory neoplasms, cystectomy is the gold standard. In this study the effects of thermochemotherapy with mitomycin C were evaluated in high-risk bladder cancer nonresponders to previous therapy.

PATIENTS AND METHODS:

Between January 2006 and December 2009, 30 patients were enrolled with recurrent stage carcinoma in situ, Ta and T1, grade G1 to G3 non-muscle-invasive bladder cancer refractory to chemotherapy or immunotherapy and so becoming suitable for radical cystectomy. All patients underwent endovesical thermochemotherapy: 16 patients underwent a prophylactic scheme and 14 patients underwent an ablative scheme.

RESULTS:

All the patients completed the study. The mean follow-up for all the patients enrolled was 14 months. Thirteen of 30 patients (43.30%) were disease free and 17 patients (56.70%) had recurrence. In the prophylactic group, 7 of 16 patients (43.75%) were disease free and 9 patients (46.25%) had tumor recurrence; no progression was observed. In the ablative group, 3 patients (17, 64%) had progression to muscle-invasive disease. Side effects were generally mild.

CONCLUSIONS:

Thermochemotherapy could be considered an additional tool in patients refractory to intravesical therapies before considering early cystectomy.

PMID:
22965159
DOI:
10.1159/000341912
[Indexed for MEDLINE]

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