Intravesical chemotherapy for intermediate risk non‑muscle invasive bladder cancer recurring after a first cycle of intravesical adjuvant therapy

Vito Franco, Vincenzo Serretta, Giuseppe Cicero, Rosalinda Allegro, Francesco Sommatino, Cristina Scalici Gesolfo, Vito Franco, Vincenzo Serretta

Risultato della ricerca: Article

Abstract

Context: The therapeutic strategy in intermediate risk (IR) non‑muscle invasive bladder cancer (NMIBC)recurring after intravesical therapy (IT) is not well defined. Most patients are usually retreated by BacillusCalmette‑Guerin (BCG).Aims: To evaluate the efficacy of intravesical chemotherapy (ICH) given at recurrence after the first cycleof ICH in IR‑NMIBC recurring 6 months or later.Settings and Design: Retrospective analysis of the efficacy of ICH given after previous IT.Materials and Methods: The clinical files of IR‑NMIBC patients recurring later than 6 months after transurethralresection (TUR) and IT and retreated by IT were reviewed. The patients should be at intermediate risk bothinitially and at the first recurrence. BCG should have been given at full dose. Cytology and cystoscopy wereperformed 3 monthly for 2 years and then 6 monthly.Statistical Analysis: The RFS was estimated by the Kaplan‑Meier method and the differences between treatmentgroups were compared by log‑rank test. Mann Whitney U‑test was used to compare the parameters’ distributionfor median time to recurrence. Multivariate Cox proportional hazards models were used. Results: The studyincluded 179 patients. The first IT was ICH in 146 (81.6%) and BCG in 33 (18.4%), re‑IT was ICH in 112 (62.6%)and BCG in 67 (37.4%) patients. Median time to recurrence was 18 and 16 months after first and secondIT (P = 0.32). At 3 years, 24 (35.8%) and 49 (43.8%) patients recurred after BCG and ICH, respectively (P = 0.90).No difference in RFS was found between BCG and ICH given after a first cycle of ICH (P = 0.23).Conclusions: Re‑treatment with ICH could represent a legitimate option to BCG in patients harboringIR‑NMIBC recurring after TUR and previous ICH. Prospective trials are needed.
Lingua originaleEnglish
pagine (da-a)21-25
Numero di pagine5
RivistaUrology Annals
Volume7
Stato di pubblicazionePublished - 2015

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All Science Journal Classification (ASJC) codes

  • Urology

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