– After TUR of superficial bladder tumours (G1-G3, Ta-T1), 121 patients were randomized in three groups of intravesical treatment: mitomycin C alone, mitomycin C plus epirubicin, mitomycin C plus interferon-alpha-2. At a mean follow-up of 53 months, 64 patients (52.8%) showed a recurrence. A trend (p < 0.02) in favour of the combination of mitomycin C and epirubicin was evident. The higher efficacy of this association was particularly evident when patients with primary tumours were excluded from the statistical analysis.
The aim of this study was to evaluate the clinical utility of the NMP22 test after transurethral resection of superficial transitional cell carcinoma of the bladder. The test was performed in 28 patients with histologically confirmed bladder tumours and in 41 patients who already had two consecutive negative cytological and cystoscopic results at least 3 months after TUR. In the first group the mean NMP22 value was 62.5 u/ml with a false negative rate of 18%. The specificity of the NMP22 test in 41 patients with a previous history of TCCB was 49%. No difference was detected between patients treated or not with intravesical chemotherapy. Despite its good sensitivity, the NMP22 test cannot be adopted as a routine tool in post-TUR surveillance of patients with superficial bladder cancer, due to its low specificity.
– Intravesical iontophoresis should permit higher intratumoral concentrations of a drug administered intravesically for the treatment of superficial bladder tumours. Iontophoresis was performed with mitomycin C (30 mg in 60 ml) for 20 minutes using a pulsating electric current of 20 mA. Ten patients, with a papillary marker lesion left after TUR, were treated for ablative purposes. Sixteen other patients were submitted to intravesical prophylaxis after complete TUR. Toxicity was purely local. A complete response was obtained in 6 of the 10 patients with a marker lesion.
– Forty patients affected by locally advanced carcinoma of the bladder were submitted to up-front chemotherapy followed by TUR and radiotherapy. A complete response was obtained in 27 patients (67.5%). A residual mass was present in 13 (32.5%) patients. At a mean follow-up of 38 months (range: 18–112 months), 7 patients showed a recurrence that was superficial in 3 cases and infiltrating the muscular layer in 4. Fifteen patients (37.5%), 12 of whom disease-free, are alive with a mean survival of 65 months. Five more patients died of non-related disease.
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