Results of intravesical chemo-hyperthermia in high-risk non-muscle invasive bladder cancer


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Ekin R. G. , Akarken I., Cakmak O., Tarhan H., Celik O., Ilbey Y. Ö. , ...More

Asian Pacific Journal of Cancer Prevention, vol.16, no.8, pp.3241-3245, 2015 (Journal Indexed in SCI Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 16 Issue: 8
  • Publication Date: 2015
  • Doi Number: 10.7314/apjcp.2015.16.8.3241
  • Title of Journal : Asian Pacific Journal of Cancer Prevention
  • Page Numbers: pp.3241-3245
  • Keywords: Chemohyperthermia, Mitomycin C, Non muscle-invasive bladder cancer, Recurrence, Thermochemotherapy

Abstract

Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer. Materials and Methods: Between November 2011-September 2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermia in two centers were evaluated retrospectively. Treatment consisted of 6 weekly sessions, followed by 6 sessions. Recurrence and progression rate, recurrence-free interval and side effects were examined. Analyzed factors included age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CIS assets. The associations between predictors and recurrence were assessed using multivariate Cox proportional hazard analyses. Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosed with tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was 23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24 months were 82% and 61%. There was no statistically significant difference between patient subgroups. Cox hazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrence-free. Adverse effects were seen in 53% of patients and these were frequently grades 1 and 2. Conclusions: Intravesical therapy with combination of mitomycin-C and chemohyperthermia seems to be appropriate in high-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications for standard BCG therapy.