Single Postoperative Instillation of Gemcitabine in Patients with Non-muscle-invasive Transitional Cell Carcinoma of the Bladder: A Randomised, Double-blind, Placebo-controlled Phase III Multicentre Study

Efficacy of Postoperative Bladder Irrigation with Water for Injection in Reducing Recurrence Rates of Non Muscle Invasive Bladder Cancer

“…In this retrospective study regarding the prophylactic effect of continuous intravesical instillation with water for injection after transurethral resection of non muscle invasive bladder tumors, RFR during the first year of follow up was similar to that observed in the study of Bohle et al for intermediate-risk tumors (80% vs 78,8%) and even better for grade 3 (60% vs 42,4%) and single tumours (85% vs 81%), despite the highest proportion of grade 2 and grade 3 tumours in our sample (Bohle et al, 2009). In the same study authors concluded that the single administration of gemcitabine was not more effective than administration of saline.…”

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

“…Several papers have recently suggested that chemotherapy instillation immediately after TURBT should be abandoned in non-muscle invasive bladder cancer because it prevented only small tumour recurrences; 9 was of limited benefi t in patients with multifocal, rapidly recurrent, high-grade disease, and did not seem to increase the effi cacy of subsequent protracted intravesical regimens; [10][11][12] was effi cacious mainly during the fi rst 2 years of follow-up; 25 and had no eff ect on disease progression. 6,11 In a randomised study, 12 intravesical instillation of gemcitabine immediately after TURBT was no better than placebo in terms of recurrence-free survival.…”

“…6,11 In a randomised study, 12 intravesical instillation of gemcitabine immediately after TURBT was no better than placebo in terms of recurrence-free survival. Continuous bladder irrigation with saline solution and improved TURBT techniques were postulated to underlie the low recurrence rate.…”

“…5 Meta-analyses by the European Organisation for Research and Treatment of Cancer 6 and the American Urological Association 7 reported that a single dose of intravesical chemotherapy a few hours after transurethral resection reduced recurrence in patients with low-risk and intermediate-risk non-muscle invasive bladder cancer, with negligible side-eff ects. Despite level 1 evidence supporting its use, however, disagreement persists, [8][9][10][11][12] and it is rarely given by urologists. Moreover, it has suboptimum effi cacy in intermediate-risk patients and no benefi t in high-risk patients, and there are other diffi culties: the optimum schedule and duration of treatment are not yet standardised.…”

“…The European Association of Urology 2 and, to a lesser extent, the American Urological Association 7 guidelines consequently recommended that this strategy be included in treatment plans for all patients with non-muscle invasive bladder cancer. However, disagreement persists despite level 1 evidence supporting its use, [8][9][10][11][12] and it is rarely given by urologists. 13 In laboratory 14 and clinical studies, 15 intravesical electromotive drug administration (EMDA) increased mitomycin bladder uptake, improving clinical effi cacy in high-risk non-muscle invasive bladder cancer.…”