Intravesical therapy in the management of superficial transitional cell carcinoma of the bladder: the experience of the EORTC GU Group

Newling, D. W. W.

doi:10.1038/bjc.1990.112

Cited by 30 publications

(14 citation statements)

References 17 publications

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“…Intravesical chemotherapy or immunotherapy is cur rently used in patients with superficial bladder cancer with 3 major objectives: (a) to induce complete regression of nonresectable papillary lesions of the bladder or carci noma in situ; (b) to prevent local relapse and tumor pro gression toward higher grades and stages, and finally (c) to reduce mortality [14], Different chemotherapeutic agents were able to induce complete regression of nonresectable papillary tumors and to decrease the local recurrence rate when compared to the transurethral resection alone [15,16]. Even a single intravesical instillation of doxorubicin within 2 h from TURBT proved to be effective in reduc ing local relapses by 50% in patients upon first evidence of superficial TCC of the bladder [17], Local immuno therapy by intravesical instillation of bacillus CalmetteGuérin (BCG) has been successfully used in the treatment of TCC of the bladder [18].…”

Section: Discussionmentioning

confidence: 99%

Local Immunotherapy of Superficial Bladder Cancer by Intravesical Instillation of Recombinant lnterleukin-2

Tubaro¹,

Stoppacciaro²,

Velotti³

et al. 1995

Eur Urol

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Section: Discussionmentioning

confidence: 99%

Local Immunotherapy of Superficial Bladder Cancer by Intravesical Instillation of Recombinant lnterleukin-2

Tubaro¹,

Stoppacciaro²,

Velotti³

et al. 1995

Eur Urol

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“…Especially multiple high grade tumours which extend into the lamina propria are often seen to progress to higher stage disease (Cutler et al, 1982;Pocock et al, 1982;Heney et al, 1983 (Heney, 1988;Flamm & Havelec, 1990;Newling, 1990;Soloway et al, 1990;Vogeli & Ackermann, 1990 seem to increase rather than decrease the 5-year risk of progressive disease. However, this finding was caused by the fact that more patients with a relatively poor prognosis received adjuvant therapy.…”

Section: Survivalmentioning

confidence: 99%

The clinical epidemiology of superficial bladder cancer

Kiemeney

Witjes²,

Verbeek³

et al. 1993

Br J Cancer

127

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Summary Even though the majority of patients with bladder malignancies initially present with low stage disease, the clinical epidemiology of these so-called superficial bladder tumours is not well known. In this paper, disease characteristics at initial presentation and during follow-up are described in 1,745 primary cases documented prospectively in the Netherlands. The risk of recurrent disease after primary treatment is very high: in 60% of cases, at least one recurrence is diagnosed within 5 years (95% CI: 58-62% Society, 1991). Therefore, the greatest concern in these patients is not to reduce mortality but to lower and postpone the number of recurrences (which are very common in superficial TCC) and thereby to prevent progression to invasive disease (and document) at least four random quadrant biopsies in macroscopically normal-looking urothelium (left and right lateral wall, trigone and dome) at the time of resection of the tumour(s). The therapy to be applied was transurethral resection of the tumour (TUR) in all patients. Urologists were advised to consider adjuvant intravesical instillations with chemotherapy or BCG vaccine in the case of multiple tumours. In pTI grade 3 patients more aggressive therapy, such as radical surgery or external or interstitial radiotherapy, would have to be considered. To detect recurrences, cystoscopy and urine cytology were used every 3 months in the first year after treatment. From the second year onwards, this check-up was performed every 6 months. Follow-up data concerning disease and life status were collected for each patient once every year.Between 1983 and 1990, 2,805 cases were documented. In 1991, all the data in the documentation project were reviewed using the medical files. After this check, the records of 100 cases were excluded. Of these, 30 had an inverted papilloma (which was considered to be benign), 58 had recurrent instead of primary disease at first registration, five did not have TCC in the bladder but in the upper urinary tract. In the records of seven cases, there were major inconsistences, which could not be corrected with information from the medical files. Of the remaining 2,705 cases, 1,745 (64.5%) had superficial TCC. 'Superficial' is defined as tumour extension limited to the mucosa (pTa) or the lamina propria (pTl) of the bladder wall with or without carcinoma in situ in random biopsies. In urology practice, primary carcinoma in situ (pTis) is considered to be very different from pTa and pTI tumours because of its relatively aggressive clinical behaviour. For that reason, patients with primary pTis (n = 52 in our series) were not evaluated in this study. Survival free of recurrence, survival free of progression and survival itself were measured from the data of histological diagnosis to the date of first recurrence, first evidence of disease progression and the date of death, respectively. Survival curves were based on the life table method, statistical significance being determined by the log rank test. The independence of host and tum...

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“…Mitomycin C (MMC) as an alkylating cytostatic agent is commonly used to treat NMIBC. Local administration to the bladder can be effective without causing high concentrations in the serum, and thus, causing only mild side-effects (8,12,14,16,17). Numerous clinical trials have shown that combining MMC administration with hypothermia can improve tumor ablation and prevent recurrence post-TUR.…”

Section: Introductionmentioning

confidence: 99%

“…However, NMIBC recurs in ~70% of patients post-TUR, and requires lifelong treatment (3)(4)(5)(6). Although, the recurrence rate of NMIBC is significantly decreased by TUR in combination with intravesical chemotherapy, the rate of cancer progression is not diminished (7)(8)(9)(10)(11)(12). Preventing recurrence of NMIBC after TUR remains challenging (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Bladder intracavitary hyperthermic perfusion chemotherapy for the prevention of recurrence of non-muscle invasive bladder cancer after transurethral resection

Cui

Wang

et al. 2017

Oncology Reports

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Abstract. Preventing the recurrence of non-muscle invasive bladder cancer (NMIBC) post-transurethral resection (TUR) remains challenging. The aim of the present study was to investigate the effectiveness and safety of bladder intracavitary hyperthermic perfusion chemotherapy (BHPC) for prevention of NMIBC recurrence post-TUR. Between December 2006 and December 2014, 53 patients with NMIBC who underwent TUR were randomly assigned to receive BHPC (BHPC group, 28 patients) or intravesical chemotherapy alone (chemotherapy group, 25 patients) at the Intracelom Hyperthermic Perfusion Therapy Center of Guangzhou Medical University Cancer Hospital (Guangzhou, China). BHPC was performed by combining perfusion-based hyperthermia with chemotherapeutic agent mitomycin C (MMC) in the bladder, and the chemotherapy group of patients received bladder MMC perfusion. The concentration of MMC in the perfusion fluid and serum were assessed at different time-points. Tumor recurrence, disease-free survival (DFS), and side-effects were recorded and compared between the 2 groups. Results revealed that BHPC was performed smoothly, at ~44̊C in the bladder cavity. Patients tolerated BHPC, and no side-effects were observed. Both BHPC and intravesical chemotherapy achieved a high MMC concentration in the bladder perfusion liquid, but low MMC concentration in the serum, although serum MMC concentrations in the BHPC group were significantly higher (P<0.05). The tumor recurrence rate was significantly lower (10.7 vs. 28.0%; P=0.02) and the DFS period was significantly longer (37±1.2 vs. 19±0.9 months; P=0.001) in the BHPC group than in the chemotherapy group. Our results demonstrated that BHPC is safe and effective for preventing NMIBC recurrence post-TUR and prolongs DFS.

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Intravesical therapy in the management of superficial transitional cell carcinoma of the bladder: the experience of the EORTC GU Group

Cited by 30 publications

References 17 publications

Local Immunotherapy of Superficial Bladder Cancer by Intravesical Instillation of Recombinant lnterleukin-2

Local Immunotherapy of Superficial Bladder Cancer by Intravesical Instillation of Recombinant lnterleukin-2

The clinical epidemiology of superficial bladder cancer

Bladder intracavitary hyperthermic perfusion chemotherapy for the prevention of recurrence of non-muscle invasive bladder cancer after transurethral resection

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