Introduction
Expression level of the cell proliferation marker Ki-67 correlates with the degree of differentiation of tumor cells and stage in primary patients with non-muscle-invasive bladder cancer (NMIBC), but the marker is currently not used in assessing the efficacy of adjuvant intravesical therapy and risk stratification in patients with recurrent bladder tumors.
Material and methods
A retroprospective study included 107 patients with high-risk NMIBC; the patients were divided into 2 groups. The first group included patients who received adjuvant therapy after transurethral resection of the bladder using the Bacillus Calmette-Guérin (BCG) vaccine (BCG therapy group; n = 54), the second group consisted of patients who received hyperthermic intravesical chemotherapy (HIVEC
®
therapy group; n = 53) using the device for local hyperthermia Combat BRS HIVEC
®
.
Results
Tumor recurrences were recorded in 21 (39%) patients receiving intravesical BCG therapy and in 9 (17%) patients after intravesical hyperthermic chemotherapy (p = 0.012). The expression level of Ki-67 in primary tumors did not differ; in recurrent tumors it was significantly different in both groups (32.05 ±13.80 vs 11.00 ± 6.86). The frequency of recurrence-free survival (RFS) in patients receiving chemohyperthermia was significantly higher than in patients after the BCG therapy (log-rank test result: p = 0.048).
Conclusions
Assessment of Ki-67 expression in recurrent tumors can be a criterion for the effectiveness of intravesical bladder-preserving treatment. The use of hyperthermic chemotherapy can reduce the number of radical cystectomies in a separate group of patients with NMIBC.
Objective. Comparative estimation of quality of life in patients with a high-risk musculo-noninvasive cancer of the bladder was accomplished while conduction of adjuvant intrabladder hyperthermic chemotherapy and immunotherapy with BCG vaccine.
Маterials and methods. Depending on kind of treatment, the patients were distributed into two groups: Group I - 44 patients, to whom adjuvant intrabladder immunotherapy with BCG vaccine was applied, and Group II - 41 patients, to whom intrabladder chemotherapy was conducted, using the system for local hyperthermy Combat BRS.
Results. The data from the patients interviewed, using EORTC QLQ-30 questionnaires, confirmed better quality of life in patients of Group II, who obtained intrabladder hyperthermic chemotherapy, peculiarly in accordance to indices of physical status, social adaptation and intoxication. In accordance to data of the patients’ interviewed with the help of FACT-BL questionnaire, also better results were obtained in patients of Group II in accordance to the social and functional well-being status, the urination quality and values of indices of the «Cancer of the Bladder» scale.
Conclusion. Higher quality of life was noted in patients of Group II, who obtained intrabladder hyperthermic chemotherapy. The lower quality of life in patients of Group I, who obtained immunotherapy with BCG vaccine, was connected with multiple side effects and enhanced toxicity of this therapy, accordingly.
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