Document Detail


Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC).
MedLine Citation:
PMID:  21029314     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: • To present long-term efficacy data of intravesical thermochemotherapy vs chemotherapy alone with mitomycin-C (MMC) randomly administered to patients with non-muscle-invasive bladder cancer (NMIBC) as an adjuvant treatment after complete transurethral resection.
PATIENTS AND METHODS: • In all, 83 patients with intermediate-/high-risk NMIBC, following complete transurethral resection, were randomly assigned to receive either intravesical thermochemotherapy by means of Synergo® (Medical Enterprises, Amsterdam, The Netherlands) or intravesical chemotherapy alone, for prophylaxis of tumour recurrence. • Two doses of MMC (20 mg dissolved in 50 mL distilled water administered throughout two consecutive sessions) was used as the chemotherapeutic agent in both arms. • In all, 75 patients completed the original study (35 of 42 in the treatment arm, 40 of 41 in the control arm), whose results at minimum 2-year follow-up have already been published. • Recently, the files of these patients have been updated for long-term outcome definition. Data on general health, follow-up examinations, tumour relapse or progression, and cause of death were collected and analysed.
RESULTS: • Updated complete data collection was available for 65/75 (87%) of the original patients. • The median follow-up for tumour-free patients was 91 months. The 10-year disease-free survival rate for thermochemotherapy and chemotherapy alone were 53% and 15%, respectively (P < 0.001). • An intent-to-treat analysis performed to overcome the potential bias introduced by the asymmetrical discontinuation rate still showed a significant advantage of the active treatment over the control treatment. Bladder preservation rates for thermochemotherapy and chemotherapy alone were 86% and 79%, respectively.
CONCLUSION: • This is the first analysis of long-term follow-up of patients treated with intravesical thermochemotherapy. The high rate (53%) of patients who were tumour-free 10 years after treatment completion, as well as the high rate (86%) of bladder preservation, confirms the efficacy of this adjuvant approach for NMIBC at long-term follow-up, even in patients with multiple tumours.
Authors:
Renzo Colombo; Andrea Salonia; Zvi Leib; Michele Pavone-Macaluso; Dov Engelstein
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-10-04
Journal Detail:
Title:  BJU international     Volume:  107     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-11     Completed Date:  2011-05-03     Revised Date:  2011-06-10    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  912-8     Citation Subset:  IM    
Copyright Information:
© 2010 THE AUTHORS. BJU INTERNATIONAL © 2010 BJU INTERNATIONAL.
Affiliation:
Department of Urology, University Vita-Salute San-Raffaele, Milan, Italy. colombo.renzo@hsr.it
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MeSH Terms
Descriptor/Qualifier:
Administration, Intravesical
Aged
Antibiotics, Antineoplastic / therapeutic use*
Chemotherapy, Adjuvant
Epidemiologic Methods
Female
Humans
Hyperthermia, Induced / methods*
Male
Middle Aged
Mitomycin / therapeutic use*
Neoplasm Invasiveness
Treatment Outcome
Urinary Bladder Neoplasms / drug therapy*
Chemical
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 50-07-7/Mitomycin
Comments/Corrections
Comment In:
BJU Int. 2011 May;107(10):1685; author reply 1685-6   [PMID:  21518420 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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