scholarly journals Analysis of Japanese Patients Treated with or without Long-Term Epirubicin Plus Ara-C Intravesical Instillation Therapy for Low-Grade Superficial Bladder Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Tomonori Kato ◽  
Kazushi Nomura ◽  
Fukuo Kondo ◽  
Masami Wakisaka ◽  
Akira Komiya
Keyword(s):  
Bladder Cancer ◽  
Tumor Recurrence ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Japanese Patients ◽  
Intravesical Instillation ◽  
Intravesical Chemotherapy ◽  
Low Grade ◽  
Free Rate

The high incidence of tumor recurrence following transurethral resection (TUR) represents a major problem encountered in the management of bladder cancer. This study examined the efficacy of intravesical chemotherapy in superficial bladder cancer. We retrospectively analyzed 90 Japanese cases with low-grade superficial transitional cell carcinoma (stage T1, grades 1 and 2) who were rendered tumor-free by TURBT (TUR of bladder tumor) and who thereafter were treated with or without intravesical chemotherapy. Among them, instillation was terminated in 2 patients due to adverse effects (severe but reversible chemical cystitis). Remaining 88 patients were divided into 2 groups according to therapy: the TURBT-only group(n=46), defined as patients treated with TURBT alone, and the Instillation group(n=42), defined as patients treated with weekly intravesical instillation therapies using epirubicin plus Ara-C. Recurrence-free rate was significantly higher in the Instillation group than in the TURBT-only group (p=0.02, HR = 0.457). The 5-year recurrence-free rate was 58.5% for the Instillation group and 38.6% for the TURBT-only group. Our instillation schedule represents the most intensive regimen among previously reported therapies and resulted in a 54.3% decrease in incidence of tumor recurrence. We believe that the results of this study could provide useful information on management of bladder cancer.

Short Schedule Intravesical Mitomycin Preceding Transurethral Resection for Recurrent Ta-T1, G1-G2 Bladder Cancer

1995 ◽  
Vol 81 (3) ◽  
pp. 191-193
Author(s):  
Massimo Maffezzini ◽  
Alchiede Simonato ◽  
Cristina Lodolo ◽  
Marco Raber ◽  
Giorgio Carmignani
Keyword(s):  
Bladder Cancer ◽  
Transurethral Resection ◽  
Small Volume ◽  
Superficial Bladder Cancer ◽  
Residual Disease ◽  
Intravesical Chemotherapy ◽  
Number Of Patients ◽  
Intravesical Instillations ◽  
Short Schedule

Aims and Background Intravesical instillations commonly follow resection, when all visible lesions have been removed, making impossible any direct assessment of efficacy. The study was conceived to evaluate the ablative effect on the tumor and the efficacy in reducing the risk of recurrence of short schedule intravesical chemotherapy administered before endoscopic resection. Study design Four weekly intravesical instillations of mitomycin C followed by transurethral resection (TUR) were administered to 31 patients with recurrent small volume superficial bladder cancer. Results At TUR no evidence of disease was found in 22 patients (70.9%) and residual disease in the remaining 9 (29.1%). At a median follow-up of 15 months (range, 3-33) 16 of 31 patients (51.6%) had recurrence of disease. The treatment was well tolerated. Conclusions Short-schedule intravesical chemotherapy can completely ablate small volume recurrent superficial bladder cancer in a relevant number of patients but is probably not sufficient to obtain long-term prophylaxis.

scholarly journals Disseminated BCG: Complications of Intravesical Bladder Cancer Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Uyen To ◽  
Joyce Kim ◽  
David Chia
Keyword(s):  
Bladder Cancer ◽  
Hypersensitivity Pneumonitis ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Low Grade ◽  
Newly Diagnosed ◽  
Insidious Onset ◽  
Initial Symptoms ◽  
Intravesical Bcg ◽  
Carcinoma Of The Bladder

Intravesical bacillus Calmette-Guerin (BCG) has been established as an effective treatment of superficial bladder cancer (Parker and Kommu, 2013). However, major side effects, including pneumonitis, sepsis, and even death, may occur in <5% of patients (Gonzalez et al., 2003). Here we present a case of severe disseminatedMycobacterium bovisfollowing intravesical BCG administration. Our patient is a 76-year-old gentleman with newly diagnosed superficial transitional cell carcinoma of the bladder who recently received his first intravesical BCG treatment. He initially presented with hemoptysis and was found to have extensive patchy infiltrates bilaterally. He was treated for pneumonia with antibiotics and then with steroids for hypersensitivity pneumonitis but continued to deteriorate. Due to the temporal proximity of his exposure to BCG, we administered treatment for presumed disseminated BCG infection with rifampin, isoniazid, and ethambutol. Within a 48-hour period, the patient improved dramatically. The reported cases of infection from intravesical BCG illustrate an insidious onset with initial symptoms of low-grade fevers and cystitis but may progress to pneumonitis. If the symptoms persist for more than 7 days or if there is clinical deterioration, RIPE therapy (with rifampin, isoniazid, pyridoxine, and ethambutol) and a fluoroquinolone should be administered for a 6–9-month course along with steroids for 4–6 weeks (Naudžiunas et al., 2012).

Second-Line Intravesical Gemcitabine in High Risk Superficial Bladder Cancer: Our Experience

2009 ◽  
Vol 76 (3) ◽  
pp. 178-184
Author(s):  
A. Aloisi ◽  
L. Ruggera ◽  
P. Beltrami ◽  
M.A. Cerruto ◽  
F. Zattoni
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Superficial Bladder Cancer ◽  
Transitional Cell ◽  
Tumor Stage ◽  
Intravesical Instillation ◽  
High Grade ◽  
Second Line ◽  
Bcg Therapy

Purpose Intravesical instillation of Gemcitabine may represent a useful second-line chemotherapy in case of non-muscle-invasive bladder cancer. Herein, we reported our experience with intravesical Gemcitabine in a group of patients affected by high-grade transitional cell carcinoma (TCC) of the bladder. Materials and Methods We retrospectively analyzed a total of 17 patients (15 males and 2 females), affected by high-risk superficial bladder cancer, who were refractory, intolerant or not eligible to intravesical BCG immunotherapy. Each patient received 2000 mg of Gemcitabine diluted in 100 mL of 0.9% saline solution, administered twice a week for 6 weeks. At start, TCC stage and grade were: CIS in 10 patients, TaG3 in 5 and T1G3 in the remaining 2 cases. Those with no macroscopic lesion and negative cytology and histology were considered as complete responders; those with only positive cytology as partial responders, and those with positive biopsy or evidence of macroscopic lesions as non-responders. Results Patients’ mean age was 71.5 yrs (± 7.3 yrs standard deviation). Overall, median follow-up was 12 months [interquartile range (IQR) 9–15 months]. A complete remission was achieved in 10 cases (58.8%), a partial response in 2 (11.8%), while 5 patients (29.4%) were considered as non-responders. Tumor stage and/or grade progression was observed in 26.7% of the cases. Overall, the 6-month recurrence-free survival was 33.3%. Drug toxicity was relatively low: 2 patients developed a grade II dysuria (NCI-CTC criteria); fever >38° was observed in 1 case. Conclusions Although our experience and follow-up are still rather limited to formulate any conclusive assessment, our study seems to confirm that Gemcitabine could be used as a safe and efficient intravesical chemotherapy agent even in high grade TCCs, representing a promising second-line option in those cases who failed, were intolerant or not eligible to BCG therapy. (Urologia 2009; 76: 178–84)

Comparative analysis of short-term and long-term prophylactic intravesical chemotherapy of superficial bladder cancer

1987 ◽  
Vol 20 (S1) ◽  
Author(s):  
Hideyuki Akaza ◽  
Shigeo Isaka ◽  
Kenkichi Koiso ◽  
Toshihiko Kotake ◽  
Toyohei Machida ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Comparative Analysis ◽  
Superficial Bladder Cancer ◽  
Intravesical Chemotherapy ◽  
Short Term
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