Perioperative epidural analgesia and recurrence-free survival for ovarian cancer surgery: A retrospective analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16534-e16534
Author(s):  
Dominique Koensgen ◽  
Alexander Mustea ◽  
Barbara Rosanowski ◽  
Bianca Leutzow ◽  
Thomas Hesse ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Cancer Recurrence ◽  
Cancer Surgery ◽  
Opioid Analgesia ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Group A ◽  
Group B

e16534 Background: Current experimental and clinical data suggest that perioperative factors may influence the long-term outcome after cancer surgery. Recent retrospective analyses have shown the reduction of cancer recurrence and metastatic spread in patients after tumor surgery receiving perioperative regional and neuraxial analgesia. The aim was to investigate whether perioperative epidural anesthesia is associated with the decreased disease recurrence and increased survival after primary tumor debulking in patients with ovarian cancer. Methods: Retrospective analysis of consecutive patients with primary ovarian cancer who underwent radical multivisceral surgery between 01/2003 and 12/2010 under either general anesthesia plus opioid analgesia (group A) or general anesthesia plus epidural anesthesia (group B), was performed. Cancer recurrence-free survival and total survival times after surgery were compared between the groups using Mann-Whitney test. The analysis was strengthened by Kaplan-Meier survival estimates for each group with comparison using the log-rank test. Results: Data of 105 (88%) of patients (group A: 33; group B: 72) were available for analysis. The median (interquartile range-IQR) follow-up time 27 (17-58) months. The groups were comparable regarding age, body-mass index, ASA physiological status, FIGO staging, tumor residual and use of adjuvant platinum-based chemotherapy. The median (IQR) time to recurrence of cancer was 31 (15-63) months in group A vs. 18 (10-35) months in group B (p = 0.017). Longer recurrence-free survival was associated with general anesthesia and opioid analgesia (hazard ratio 1.52; 95% confidence interval 1.4-1.56; p = 0.008). Conclusions: In contrast to previous investigations, perioperative epidural anesthesia was associated with decreased survival in patients after ovarian cancer surgery.

scholarly journals Epidural Anesthesia–Analgesia and Recurrence-free Survival after Lung Cancer Surgery: A Randomized Trial

2021 ◽  
Author(s):  
Zhen-Zhen Xu ◽  
Huai-Jin Li ◽  
Mu-Han Li ◽  
Si-Ming Huang ◽  
Xue Li ◽  
...  
Keyword(s):  
Lung Cancer ◽  
General Anesthesia ◽  
Survival Time ◽  
Epidural Anesthesia ◽  
Lung Cancer Surgery ◽  
Hazard Ratio ◽  
Cancer Surgery ◽  
Recurrence Free Survival ◽  
Cancer Specific Survival ◽  
Free Survival

Background Regional anesthesia and analgesia reduce the stress response to surgery and decrease the need for volatile anesthesia and opioids, thereby preserving cancer-specific immune defenses. This study therefore tested the primary hypothesis that combining epidural anesthesia–analgesia with general anesthesia improves recurrence-free survival after lung cancer surgery. Methods Adults scheduled for video-assisted thoracoscopic lung cancer resections were randomized 1:1 to general anesthesia and intravenous opioid analgesia or combined epidural–general anesthesia and epidural analgesia. The primary outcome was recurrence-free survival (time from surgery to the earliest date of recurrence/metastasis or all-cause death). Secondary outcomes included overall survival (time from surgery to all-cause death) and cancer-specific survival (time from surgery to cancer-specific death). Long-term outcome assessors were blinded to treatment. Results Between May 2015 and November 2017, 400 patients were enrolled and randomized to general anesthesia alone (n = 200) or combined epidural–general anesthesia (n = 200). All were included in the analysis. The median follow-up duration was 32 months (interquartile range, 24 to 48). Recurrence-free survival was similar in each group, with 54 events (27%) with general anesthesia alone versus 48 events (24%) with combined epidural–general anesthesia (adjusted hazard ratio, 0.90; 95% CI, 0.60 to 1.35; P = 0.608). Overall survival was also similar with 25 events (13%) versus 31 (16%; adjusted hazard ratio, 1.12; 95% CI, 0.64 to 1.96; P = 0.697). There was also no significant difference in cancer-specific survival with 24 events (12%) versus 29 (15%; adjusted hazard ratio, 1.08; 95% CI, 0.61 to 1.91; P = 0.802). Patients assigned to combined epidural–general had more intraoperative hypotension: 94 patients (47%) versus 121 (61%; relative risk, 1.29; 95% CI, 1.07 to 1.55; P = 0.007). Conclusions Epidural anesthesia–analgesia for major lung cancer surgery did not improve recurrence-free, overall, or cancer-specific survival compared with general anesthesia alone, although the CI included both substantial benefit and harm. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Total Intravenous Anesthesia versus Inhalation Anesthesia for Breast Cancer Surgery

2019 ◽  
Vol 130 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Seokha Yoo ◽  
Han-Byoel Lee ◽  
Wonshik Han ◽  
Dong-Young Noh ◽  
Sun-Kyung Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Retrospective Cohort ◽  
Cancer Recurrence ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Recurrence Free Survival ◽  
Inhalation Anesthesia ◽  
Free Survival ◽  
Volatile Anesthesia

Abstract EDITOR’S PERSPECTIVE What We Know about This Topic IV anesthesia may impair anticancer immunity less than volatile anesthesia and therefore reduce recurrence risk What This Article Tells Us That Is New In a large propensity-matched retrospective cohort analysis, the authors compared total IV and volatile anesthesia for breast cancer surgery Recurrence hazard was similar with each approach Selection of IV or volatile anesthesia should be based on factors other than cancer recurrence Background The association between type of anesthesia used and recurrence of cancer remains controversial. This retrospective cohort study compared the influence of total IV anesthesia and inhalation anesthesia on the primary outcome of recurrence-free survival after breast cancer surgery. Methods The authors reviewed the electronic medical records of patients who had breast cancer surgery at a tertiary care teaching hospital between January 2005 and December 2013. The patients were grouped according to whether IV or inhalation anesthesia was used for surgery. Propensity score matching was used to account for differences in baseline characteristics. Kaplan–Meier survival curves were constructed to evaluate the influence of type of anesthesia on recurrence-free survival and overall survival. The risks of cancer recurrence and all-cause mortality were compared between each type of anesthesia. Results Of 7,678 patients who had breast cancer surgery during the study period, data for 5,331 patients were available for analysis (IV group, n = 3,085; inhalation group, n = 2,246). After propensity score matching, 1,766 patients remained in each group. Kaplan–Meier survival curves showed that there was no significant difference in recurrence-free survival or overall survival between the two groups, with 5-yr recurrence-free survival rates of 93.2% (95% CI, 91.9 to 94.5) in the IV group and 93.8% (95% CI, 92.6 to 95.1) in the inhalation group. Inhalation anesthesia had no significant impact on recurrence-free survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.32; P = 0.782) or overall survival (hazard ratio, 0.96; 95% CI, 0.69 to 1.33, P = 0.805) when compared with total IV anesthesia. Conclusions The authors found no association between type of anesthesia used and the long-term prognosis of breast cancer. The results of this retrospective cohort study do not suggest specific selection of IV or inhalation anesthesia for breast cancer surgery.

scholarly journals Postoperative Radiotherapy Omitting Level Ⅳ for Locally Advanced Supraglottic and Glottic Laryngeal Carcinoma

2021 ◽  
Vol 20 ◽  
pp. 153303382098587
Author(s):  
Yang Wu ◽  
Longzhen Zhang ◽  
Tianyou Tang ◽  
Liantao Li ◽  
Liang Li ◽  
...  
Keyword(s):  
Laryngeal Carcinoma ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Recurrence Free Survival ◽  
Remarkable Difference ◽  
Free Survival ◽  
Regional Nodal Recurrence ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Cervical lymph nodes metastases are one of the most significant prognostic factors in patients with laryngeal carcinoma, whether treatment by surgery or by radiotherapy. The current study retrospected the postoperative radiotherapy of locally advanced supraglottic and glottic laryngeal carcinoma (at a greater risk of lymph node metastasis) to determine the effect of radiotherapy excluding cervical level Ⅳ lymph nodes. Methods: Patients of supraglottic type and glottic type were irradiated with level Ⅳ from January 2012 to June 2013, without level Ⅳ from July 2013 to December 2014, according to physicians’ decision. Ninety-three patients were selective neck irradiation (SNI) of levels Ⅱ-Ⅳ (Group A) and 87 patients were SNI of levels Ⅱ and Ⅲ (Group B). The comparison between Group A and Group B was made with observation of clinical risk of recurrence and radiation complications, as well as overall survival (OS), progress-free survival (PFS) and regional nodal recurrence-free survival. Results: No remarkable difference was observed in the distribution of recurrence, levels of relapse, OS, PFS and regional nodal recurrence-free survival between the 2 groups (p > 0.05). Mean radiation dose at level Ⅳ, thyroid and cervical esophagus showed significant difference between the 2 therapeutic groups (p < 0.01). As regard radiation complications, no significant difference was found in radiation dermatitis of any grade between the 2 groups (p > 0.05). However, there was remarkable difference in clinical hypothyroidism and radiation esophagitis between Group A and Group B (p < 0.05). Conclusions: Radiotherapy after surgery omitting level Ⅳ may improve the quality of life in patients with locally advanced supraglottic and glottic laryngeal carcinoma, won’t worsen the prognosis as well.

Randomized study of intravesical chemotherapy using pirarubicin in patients with non-muscle-invasive bladder cancer in Japan: Comparing one immediate postoperative intravesical chemotherapy with short-term adjuvant intravesical chemotherapy after TURBT: Subanalysis in patients with intermediate risk.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 4536-4536
Author(s):  
Yoshio Naya ◽  
Kazuya Mikami ◽  
Natsuki Takaha ◽  
Koji Okihara ◽  
Tsuneharu Miki ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Survival Rates ◽  
Intravesical Instillation ◽  
Intravesical Chemotherapy ◽  
Rank Test ◽  
Intermediate Risk ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Group A ◽  
Group B

4536 Background: The objective is to evaluate the efficacy defining of 2-year tumor recurrence free rate of intravesical chemotherapy using pirarubicin (THP) for patients with intermediate risk. Methods: Between October 2010 and January 2015, 206 patients were enrolled in this study and finally 113 were randomized to one immediate postoperative intravesical instillation of THP 30mg (Group A), or additional intravesical instillation of THP 30mg weekly for 8 weeks after single postoperative instillation (Group B). The recurrent risk was stratified using EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder, the 2009 update. Of 113, 100 with intermediate risk were analyzed in this study. The patients were examined by cystoscopy and urine cytology every 3 months after trans urethral resection to determine bladder tumor recurrence. The primary endpoint was 2 year-recurrence-free survival rates. A statistical analysis was performed by SAS (SAS Institute Inc., Cary, USA). Results: The 2-year recurrence free survival rates were 66.2% in Group A and 86.1% in Group B, respectively (log rank test, p = 0.0043). In patients with recurrence score between 5 and 9, the 2-year recurrence free survival was 92.3% in Group B and 22.2% in Group A (log rank test, p = 0.0013). Cox regression analysis revealed that only additional instillation of THP was significant independent factor for recurrence free rate in patients with intermediate risk. There was no patient with progression during this period. Frequent adverse effects were frequent urination and micturition pain without severe adverse effect (Grade 3 or more). Limitation of this study is a failure to enroll sufficient number for statistical analysis. Conclusions: Additional instillation of THP 30mg weekly for 8 weeks reduced the risk of tumor recurrence without severe toxicity in NMIBC patients with intermediate recurrent risk.

Comparison of triweekly cisplatin regimens in definitive chemoradiotherapy for locally advanced head and neck cancer: A propensity score matching analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18007-e18007
Author(s):  
Yu Fujiwara ◽  
Yasuyoshi Sato ◽  
Naoki Fukuda ◽  
Naomi Hayashi ◽  
Xiaofei Wang ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Propensity Score ◽  
Head And Neck ◽  
Propensity Score Matching ◽  
Neck Cancer ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Group A ◽  
Group B

e18007 Background: Concurrent chemoradiotherapy (CCRT) with cisplatin (CDDP) is a standard treatment for locally advanced head and neck cancer (LAHNC) in the definitive setting. Three cycles of 100 mg/m2 CDDP for every three weeks (Q3W) are now recommended but compliance with CCRT is relatively low due to its severe toxicity. Therefore, the potential de-escalation strategies for LAHNC have been discussed to decrease the therapeutic toxicity. Methods: Patients with LAHNC who underwent definitive CCRT with CDDP between 2012 and 2018 at The Cancer Institute Hospital of Japanese Foundation for Cancer Research were analyzed. Patients were classified into two groups based on the planned CDDP dose: (A) 100 mg/m2 and (B) 80 mg/m2 Q3W for three times. One-to-one propensity score matching was performed to minimize bias between two groups. After patients in two groups were matched by using propensity score, the overall survival (OS), recurrence-free survival (RFS), local recurrence-free survival (LRFS), and metastatic recurrence-free survival (MRFS) were analyzed by the Kaplan-Meier method with the Cox proportional hazards model. The follow-up term was set as two years to evaluate the early survival benefit. The dose and density of CDDP and the objective adverse events were also assessed. Results: A total of 304 patients were included with the median age of 62 (Interquartile range [IQR]: 54-67) years. Among them, 249 patients (82%) were male. Patients were treated with 100 mg/m2 CDDP (n = 145) and 80 mg/m2 CDDP (n = 159) regimens. After the propensity score matching, 119 patients were included in each group, respectively. There were no significant differences in baseline characteristics between two propensity-matched cohorts. The median follow-up time was 24 months in each group. Two-year OS was 93.0% (95% confidence interval [CI]: 88.4-97.8) in group A and 94.9% (91.0-99.0) in group B. Two-year RFS was 86.5% (80.6-92.9) in group A and 83.1% (76.6-90.1) in group B, respectively. No significant difference was observed in OS (Hazard ratio [HR] = 1.42, 95% CI: 0.49-4.08, p = 0.52), RFS (HR = 0.81, 95% CI: 0.42-1.57, p = 0.54), LRFS (HR = 0.57, 95% CI: 0.24-1.36, p = 0.20), and MFS (HR = 1.32, 95% CI: 0.52-3.35, p = 0.56). The median cumulative dose of CDDP was significantly higher in group A (300 mg, interquartile range [IQR]: 240-300) than in group B (240 mg, IQR:160-240) but the frequency of hematological, hepatic, renal, electrolytic, and grade 3-5 any adverse events was not significantly different between two groups. Conclusions: Our study showed no survival difference at 2-year follow-up between 100 mg/m2 and 80 mg/m2 CDDP regimens of definitive CCRT for LAHNC. This result could support the tide of the de-escalation strategy in head and neck cancer treatment. Longer follow-up is necessary and further prospective trials comparing CDDP dosage are warranted.

The Role of Adjuvant Chemotherapy in Surgical Stages I-II Serous and Clear Cell Carcinomas and Carcinosarcoma of the Endometrium: A Collaborative Study

2011 ◽  
Vol 21 (2) ◽  
pp. 332-336 ◽  
Author(s):  
Ingrid Vandenput ◽  
Jone Trovik ◽  
Ignace Vergote ◽  
Philippe Moerman ◽  
Karin Leunen ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Adjuvant Chemotherapy ◽  
Clear Cell ◽  
Early Stage ◽  
Surgical Staging ◽  
Recurrence Free Survival ◽  
Type Ii ◽  
Free Survival ◽  
Group A ◽  
Group B

Objective:To assess the impact of adjuvant chemotherapy in early surgically staged type II endometrial cancer (serous [S], clear cell carcinoma [CC]) and carcinosarcomas (CS) on recurrence and survival.Materials and Methods:Patients diagnosed with stages I-II S-CC and CS after comprehensive surgical staging were retrospectively collected. Surgical staging was defined as pelvic lymphadenectomy of more than 11 nodes harvested and exploration of the upper abdomen, with our without omentectomy. Groups with (group A) and without (group B) platinum-based chemotherapy were compared.Results:We identified 69 patients with a mean age of 66 years (range, 48-88 years). Both groups showed similar baseline characteristics. Group A consisted of 34 patients (23 S-CC, 11 CS) with 10 (29%) recurrences outside the pelvis (7 S-CC, 3 CS). Group B included 35 patients (28 S-CC, 7 CS) of which 10 (29%) developed recurrence outside the pelvis (7 S-CC, 3 CS). The median recurrence-free survival was 22 months (range, 13-51 months) for group A versus 10 months (range, 1-59 months) for group B (P= 0.437). Five patients (15%) of group A and 9 (26%) of group B died of disease after a median follow-up of 29 months (range, 20-59 months) and 17 months (range, 4-64 months), respectively (P= 0.168).Conclusion:Recurrences in early-stage type II endometrial cancer and carcinosarcomas occur irrespective of adjuvant chemotherapy, but recurrence-free survival is prolonged when adjuvant chemotherapy is administered. Only prospective randomized intergroup trials can address the benefit of adjuvant chemotherapy in early-stage high-risk endometrial cancer.

scholarly journals High Preoperative Serum sVCAM-1 Concentration as a Predictor of Early Ovarian Cancer Recurrence

2020 ◽  
Author(s):  
Marina Jakimovska ◽  
Katarina Černe ◽  
Ivan Verdenik ◽  
Borut Kobal
Keyword(s):  
Ovarian Cancer ◽  
Serum Level ◽  
Serum Concentration ◽  
Cancer Recurrence ◽  
Potential Marker ◽  
Preoperative Serum ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: Role of soluble vascular cell adhesion molecule-1 (sVCAM-1) in ovarian cancer is largely unclear. It was shown that mesothelial expression mediates tumour cell invasion and is associated with metastases in advanced ovarian cancer.Results: Mean sVCAM-1 serum concentration in all patients before operation was 1564.68 ± 435.65 ng/ml while mean ascites level was 801.84 ±244.35 ng/ml. Follow up period was minimum 27 and the maximum 58 months. Patients were divided in two groups according to time to recurrence. Group A: 20 patients with disease progress or relapse within 12 months (mean serum level 1660.54±417.93 ng/ml; mean ascites level 827.92±290.36) and group B: 17 patients with tumour relapse after more than 12 months (mean serum level 451.91±441.15ng/ml; mean ascites level 771.16±179.93). There was statistically significant difference in serum concentration and not in ascites concentrations of sVCAM-1, grade, histology and stage and tumour between the groups. There was a correlation between serum and ascites concentrations in group A and not in the patients from group B. Increased sVCAM-1 concentration in serum and ascites relates to advance ovarian cancer.Conclusions: This is the first study demonstrating that higher serum sVCAM-1 concentrations at the time of diagnosis might be predictive for early relapse. Serum sVCAM-1 can be potential marker for ovarian cancer follow-up.

scholarly journals Video-assisted thoracoscopic thymectomy is feasible for large thymomas: a propensity-matched comparison

2020 ◽  
Vol 30 (4) ◽  
pp. 565-572
Author(s):  
Wenhan Weng ◽  
Xiao Li ◽  
Shushi Meng ◽  
Xianping Liu ◽  
Peng Peng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Propensity Score Matching Analysis ◽  
Video Assisted ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract OBJECTIVES Video-assisted thoracoscopic thymectomy is becoming the preferable approach for early-stage thymoma. However, large thymomas are still recognized as a relative contraindication due to the possible risk of incomplete resection or capsular disruption. Thus, the aim of this study is to evaluate the feasibility of video-assisted thoracoscopic thymectomy for large thymomas. METHODS Patients diagnosed with Masaoka stage I–IV thymoma between April 2001 and December 2018 were retrospectively reviewed. All patients were divided into 2 groups: thymoma &lt;5.0 cm (group A) and thymoma ≥5.0 cm (group B). Propensity score matching analysis was performed to compare postoperative results. Recurrence-free survival and overall survival were compared for oncological evaluation. RESULTS A total of 346 patients were included in this study. In the propensity score matching analysis, 126 patients were included both in group A and group B. There was no significant difference between these 2 groups in terms of the R0 resection rate (95.2% vs 94.4%, P = 1.000), conversion rate (1.6% vs 3.2%, P = 0.684), operation time (119.4 ± 48.4 vs 139.1 ± 46.6 min, P = 0.955), blood loss (93.2 ± 231.7 vs 100.5 ± 149.3 ml, P = 0.649), duration of chest drainage (2.7 ± 1.6 vs 2.8 ± 2.0 days, P = 0.184), length of hospitalization (5.0 ± 3.9 vs 5.2 ± 2.9 days, P = 0.628) or postoperative complications (5.9% vs 8.5%, P = 0.068). There was no significant difference between these 2 groups in terms of the overall survival (P = 0.271) and recurrence-free survival (P = 0.288). CONCLUSIONS Video-assisted thoracoscopic thymectomy is a safe and effective approach for large thymomas (≥5 cm) with comparable surgical and oncological results.

A randomized trial comparing two different retention periods of intravesical pirarubicin instillation for intermediate risk non-muscule invasive bladder cancer (NMIBC) after transurethral resection.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 384-384
Author(s):  
Yutaka Kasejima ◽  
Wataru Takahashi ◽  
Yoshiaki Kawano ◽  
Takahiro Yamaguchi ◽  
Ken-ichiro Tanoue ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Intravesical Instillation ◽  
Intermediate Risk ◽  
Recurrence Free Survival ◽  
Prophylactic Effect ◽  
Free Survival ◽  
Significant Difference ◽  
Group A ◽  
Group B

384 Background: Anthracyclines are recommended reagents for one immediate intravesical instillation after transurethral resection (TUR) and additional adjuvant instillation in intermediate risk NMIBC to reduce the risk of recurrence. Several studies have showed that Pirarubicin (THP), an anthracycline analogue, can rapidly penetrate tumor tissue after intravesical instillation. Therefore long instillation time (e.g. 120 min) may not be required for its prophylactic effect against recurrence without compromising its efficacy. Methods: This randomised, prospective, open-label trial intended to enroll 160 pts with primary NMIBC with intermediate risk based on EORTC criteria. Pts who seemed likely to be at intermediate risk were provisionally registered and then randomised into two groups with different intravesical THP retention times before TUR, (a) 30 min versus (b) 120 min. The registration was finally confirmed by pathology results of TUR. All registered pts received initial THP instillation within 24 hr after TUR and then intended to continue weekly repetitive THP instillation for a total of 9 treatments. Follow-up period is 4 years. Primary endpoint is change from baseline in quality of life measurements (e.g. OABSS and I-PSS), which were evaluated prior to each THP intravesical instillation. Secondary endpoint is recurrence-free survival. Results: 126 pts were enrolled for provisional registration. After excluding pts due to the result of pathology by TUR, 29 pts were assigned to group (a), and 26 pts to group (b). Although not statistically significant, there is a trend that group (a) is less prone to increase in OABSS after 3rd instillation compared to group (b). Log-rank test shows that there is no significant difference in recurrence-free survival between the groups during follow-up period (HR = 2.161, 95% C.I.: 0.4317-10.82, p= 0.3484). Conclusions: Shortening intravesical instillation period to 30 min has little effect on reducing the adverse effect of THP. However, it does not compromise the prophylactic effect on recurrence in intermediate risk NMIBC pts. Clinical trial information: UMIN000006861.

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