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The best management of superficial bladder tumours: Comparing TUR alone versus TUR combined with intravesical chemotherapy modalities?

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Abstract

To compare retrospectively the recurrence rates of TUR alone versus different intravesical chemotherapy modalities in superficial bladder cancer cases, 187 patients with stage Ta and T1 bladder tumours were treated with transurethral resection followed by adjuvant intravesical chemotherapy with mitomycin, BCG or epirubicin or by transurethral resection alone. All patients in this study had historically proven transurethrally resectable primary, category Ta and T1 transitional cell carcinoma (TCC) of the bladder. Group I included transurethral resection alone, and the other groups included intravesical mitomycin-C(Group II), BCG (Group III) and epirubicin (Group IV) therapies after transurethral resection. 146 male and 41 female patients (78% male and 22% female patients) in this study were diagnosed as primary TCC bladder tumours. Only 52 of them were stage Ta and 135 of them were stage T1 bladder tumours. Examining the histological grade of the bladder tumours, 88 (47%) of the patients had grade I, 53 (28%) had grade IIa, 30 (16%) had grade IIb and remaining 16 (9%) had grade III bladder cancers. The recurrence rates were 25% for Group I, 23.8% for Group II, 26.2% for Group III and 22.7% for Group IV. These values were given with disregarding the grade and volume of the bladder tumours. For solitary, less than 3 cm low grade tumours (grade I, IIa) recurrence rates were 16% for Group I, 15.4% for Group II, 17.8% for Group III, 17.2% for Group IV (p> 0.05). As a result of this retrospective study, for patients with low grade, stage Ta and T1 tumours TUR alone may be the best treatment modality. Although intravesical chemotherapy is effective in decreasing short-term incidences of tumour recurrence, it has not decreased long-term incidences of tumour recurrence. The high cost and adverse side effects of intravesical chemotherapy should also be taken into consideration in superficial, single, low grade tumours of bladder.

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References

  1. Soloway MS, Pento PE. Superficial bladder cancer; diagnosis, surveillance and treatment. J Cell Biochem Suppl 1992; 16: 120–127.

    Article  Google Scholar 

  2. Heney NMet al. Progression and recurrence. J Urol 1983; 130: 1083.

    PubMed  CAS  Google Scholar 

  3. Carbin BE et al. Grading of human urothelial carcinoma based on nuclear atypia and mitotic frequency. II. Prognostic importance. J Urol 1991; 145(5): 972–975.

    PubMed  CAS  Google Scholar 

  4. Miyanaga N, Akaza H, Koiso K. Superficial bladder cancer: prophylaxis of recurrence and progression. Gan To Kagaku Ryoho 1991; 18(14): 2369–2374.

    PubMed  CAS  Google Scholar 

  5. Fitzpatrick JM et al. Superficial bladder tumours (stage p Ta grades 1&2): The importance of recurrence pattern following initial resection. J Urol 1986; 135: 920.

    PubMed  CAS  Google Scholar 

  6. Rübben H, Lutzeyer W, Fischer N, Deutz F, Langrange W, Giani G and Members of the Registry for Urinary Tract Tumours. Natural history and treatment of low and high risk superficial bladder tumours. J Urol 1988; 139: 283.

    PubMed  Google Scholar 

  7. Newling D. Intravesical therapy in the management of superficial transitional cell carcinoma of the bladder: Experience of the EORTC group. Br J Cancer 1990; 61: 497–499.

    PubMed  CAS  Google Scholar 

  8. Pawinski A et al. A combined analysis of European Organization for Research and Treatment of Cancer, and Medical Research Council randomized clinical trials for the prophylactic treatment of stage TaT1 bladder cancer. J Urol 1996; 156(6): 1934–1940, discussion 1940– 1941.

    Article  PubMed  CAS  Google Scholar 

  9. Schulman CC et al. Prophylactic chemotherapy of superficial transitional cell bladder carcinoma: an EORTC randomized trial comparing thiotepa, an epipodophyllotoxin (VM26) and TUR alone. Eur Urol 1982; 8(4): 207–212.

    PubMed  CAS  Google Scholar 

  10. Oosterlinck Wet al. A prospective European Organization for Research and Treatment of cancer Genitourinary Group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single stage Ta, T1 papillary carcinoma of the bladder. J Urol 1993; 149: 749.

    PubMed  CAS  Google Scholar 

  11. Kurth KH et al. Adjuvant chemotherapy of superficial transitional cell bladder carcinoma: preliminary results of a European organization for research on treatment of cancer. Randomized trial comparing doxorubicin hydrochloride, ethoglucid and transurethral resection alone. J Urol 1984; 132(2): 258–262.

    PubMed  CAS  Google Scholar 

  12. Newling DW et al. Tryptophan metabolites, pyridoxine (vitamin B6) and their influence on the recurrence rate of superficial bladder cancer. Results of a prospective, randomised phase III study performed by the EORTC Genito-Urinary Group. Eur Urol 1995; 27(2): 110–116.

    PubMed  CAS  Google Scholar 

  13. Tolley DA, Hargreave TB, Smith PA. Effect of intravesical mitomycin-C on recurrence of newly diagnosed superficial bladder cancer: interim report from the Medical Research Council Subgroup on Superficial Bladder Cancer (Urological Cancer Working Party). Br Med J 1988; 296: 1759.

    Article  CAS  Google Scholar 

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Altay, B., Girgin, C., Kefi, A. et al. The best management of superficial bladder tumours: Comparing TUR alone versus TUR combined with intravesical chemotherapy modalities?. Int Urol Nephrol 32, 53–58 (2000). https://doi.org/10.1023/A:1007199932271

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