Natural History and Treatment of Low and High Risk Superficial Bladder Tumors

Abstract

Since 1979 a prospective randomized trial was done to examine the efficacy of intravesical doxorubicin as prophylaxis against recurrence. After complete transurethral resection of the tumor, patients were divided into 3 groups at random: group 1-no further treatment after transurethral resection, group 2-doxorubicin twice weekly for 6 weeks and group 3-doxorubicin for 1 year. A total of 268 patients entered the study. Neither frequency of recurrences, tumor progression nor survival rate was improved significantly by the adjuvant treatment, so that only a limited number of patients will profit by instillation therapy. Analysis of previously reported data suggests that patients with superficial bladder tumors can be stratified into groups with appreciable differences in risk of progression. With regard to these results a differentiated use of a "wait and see" adjuvant intravesical therapy and more aggressive treatment after transurethral resection of superficial bladder tumors seems to be indicated rather than a general practice of chemoprophylaxis.

The Schedule and Duration of Intravesical Chemotherapy in Patients with Non–Muscle-Invasive Bladder Cancer: A Systematic Review of the Published Results of Randomized Clinical Trials

“…In another study comparing 12 instillations of Adriamycin during 6 wk to an additional 15 instillations to 1 yr, no difference was found [22]. A further study comparing 4 mo (40 mg/40 ml) to 7 mo (30 mg/40 ml) to 12 mo (20 mg/40 ml) of epirubicin found a higher percentage of patients with recurrence on the 12-mo arm, but treatment duration is confounded with drug concentration so no conclusions can be drawn from this study concerning the optimal duration of treatment [23].…”

Biomarkers for detection and surveillance of bladder cancer

“…However, these tumours have a 30% to 70% recurrence rate and may progress to invasive cancers in 10% to 30% of patients; progression greatly increases the risk of metastasis and subsequent mortality. [2][3][4] For this reason, the early detection of bladder tumours is essential Lorne I. Budman, MSc; Wassim Kassouf, MD; Jordan R. Steinberg, MD…”

Icaritin acts synergistically with epirubicin to suppress bladder cancer growth through inhibition of autophagy

“…Transurethral resection (TUR) is the primary regimen for patients with superficial bladder tumors (stages T a , T 1 or T is ) (3). However, the recurrence rate within 5 years after TUR is as high as 50-70% (4), and 10-20% of them progressed to muscle-invasive disease (5). The anthracycline epirubicin (EPI) is the first line treatment routinely used in patients with bladder cancer after TUR (6).…”