Introduction and Objectives
To compare transurethral resection only with transurethral resection plus adjuvant instillational treatment for non-invasive (Ta,T1) bladder cancer.
Material and Methods
Between 2000 and April 2005, 185 patients with Ta and T1 bladder cancers were included in this study. The patients were divided in two groups: Group A including 81 patients who were treated (2000–2002) with transurethral resection of the bladder tumours (TURB). Followup: 76–108 months (mean 86 months). Group B including 104 patients with TURB, 1 instillation with 50 mg of Epirubicin in the first 6 p.o. hours. Follow-up 44–80 months (mean 62 months). When we received the pathological report, the patients were divided, according to EAU protocols risk factors, in 3 categories: Low risk: 7 patients. They did not receive any other treatment only follow-up (cystoscopy, cytology) at 3 months, after 19 months, then every year. Medium risk: 45 patients. 29 without treatment, 13 with intravesical chemotherapy and 9 with BCG (according to their option). High risk: 52 patients, 41 receiving intravesical BCG. The follow-up was performed every 3 months in the first year, 4 months in the 2nd year, 6 months in the 3rd and 4th year, than every year.
Results
In group A, the percent of recurrencies according to the risk categories are: 30%, 37.5%, 58%. The total recurrence in group A is 44.4%. In group B, the percent of recurrencies are: 0%, 20.4%, 41.5%. The total recurrence is 29.8%. The benefit of 1 instillation with Epirubicin post-TURB is 10.4%, particularly for low risk group is 30%. Intravesical chemotherapy and 21.4% benefit regarding recurrence; BCG add 22.4% benefit. The progression rate in group A are: 0%, 12.5%, 29%. The global progression is 17.2%. In the group B, the progression rate is: 0%, 6.8%, 17%. The global progression is 11.5%.
Conclusions
The study indicated a significant benefit in favor of the adjuvant instillational treatment group, reducing the percent of tumor recurrence from 44.4% to 29.8% (difference is 14.6%); regarding the progression rate the benefit is 5.7% (from 17.2% to 11.5%).
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
