Urol. praxi. 2022;23(2):76-79
Intravesical chemotherapy in patients with NMIBC
- Urologická klinika VFN a 1. LF UK, Praha
When treating patients with bladder cancer, it is important to classify tumours into muscle-infiltrating and non-infiltrating tumours since both the prognosis and treatment differ substantially in these two groups. Non-infiltrating bladder tumours are associated with a very heterogeneous prognosis, the estimation of which is essential for choosing the right type of adjuvant therapy. The mainstay of treatment for non-infiltrating tumours is transurethral resection, following which it is important to determine prognostic factors in order for the treatment to be successful. Evaluation of these individual factors allows the inclusion of patients in prognostic groups according to the estimated risk of progression. A different method of subsequent treatment and follow-up is recommended for each risk group. Adjuvant therapy consists in intravesical chemotherapy or immunotherapy. It must be emphasized that instillation therapy is indicated in every patient after transurethral resection, with the choice of the therapeutic agent and administration regimen being dependent on the individual prognosis. The benefit of intravesical chemotherapy has been shown in low- and medium-risk groups of patients; in high-risk patients, intravesical immunotherapy is more effective.
Keywords: bladder carcinoma, NMIBC, intravesical chemotherapy, cytostatic drugs, TUR-BT.
Received: February 9, 2022; Revised: February 9, 2022; Accepted: February 19, 2022; Prepublished online: February 19, 2022; Published: June 1, 2022 Show citation
References
- Národní onkologický registr.: http://ksrzis.cz/registry‑pro‑odborniky/narodni‑zdravotni‑registry/nor/nor.html.
- Sylvester RJ, Rodriguez O, Hernandez V, et al. European Association of Urology (EAU) Prognostic Factor Risk Groups for Non‑muscle‑invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel. Eur Urol. 2021;79(4):480-488.
Go to original source... 
Go to PubMed... - Babjuk M, Burger M, Compérat E, et al. The European Association of Urology (EAU) Working group on Oncological urology. Guidelines on Non‑uscle‑invasive bladder cancer. EAU, 2021.
- Shang PF, et al. Intravesical Bacillus Calmette‑Guerin versus epirubicin for Ta and T1 bladder cancer. Cochrane Database Syst Rev. 2011:CD006885. Go to original source...
- Elmamoun MH, et al. Destruction of the bladder by single dose Mitomycin C for low‑stage transitional cell carcinoma (TCC) - avoidance, recognition, management and consent. BJU Int. 2014;113:E34. Go to original source... Go to PubMed...
- Soloway MS, et al. Urothelial susceptibility to tumor cell implantation: influence of cauterization. Cancer. 1980;46:1158. Go to original source...
- Pode D, et al. The mechanism of human bladder tumor implantation in an in vitro model. J Urol.1986;136:482. Go to original source... Go to PubMed...
- Bohle A, et al. Inhibition of bladder carcinoma cell adhesion by oligopeptide combinations in vitro and in vivo. J Urol. 2002;167:357. Go to original source... Go to PubMed...
- Sylvester RJ, et al. Systematic Review and Individual Patient Data Meta‑analysis of Randomized Trials Comparing a Single Immediate Instillation of Chemotherapy After Transurethral Resection with Transurethral Resection Alone in Patients with Stage pTa‑pT1 Urothelial Carcinoma of the Bladder: Which Patients Benefit from the Instillation? Eur Urol. 2016;69:231. Go to original source... Go to PubMed...
- Huncharek M, et al. Impact of intravesical chemotherapy on recurrence rate of recurrent superficial transitional cell carcinoma of the bladder: results of a meta‑analysis. 2001;21(1B):765-769.
- Tabayoyong WB, et al. Systematic review on the Utilization of Maintenance Intravesical Chemotherapy in the Management of Non‑muscle‑invasive Bladder cancer. Eur Urol. Focus. 2018;4:512-521. Go to original source... Go to PubMed...
- Sylvester RJ, et al. The schedule and duration of intravesical chemotherapy in patients with non‑muscle‑invasive bladder cancer: a systematic review of the published results of randomized clinical trials. Eur Urol, 2008;53:709. Go to original source... Go to PubMed...
- O'Brien T, et al. Prevention of bladder tumours after nephroureterectomy for primary upper urinary tract urothelial carcinoma: a prospective, multicentre, randomised clinical trial of a single postoperative intravesical dose of mitomycin C (the ODMIT‑C Trial). Eur Urol. 2011;60:703. Go to original source... Go to PubMed...
- Ito A, et al. Prospective randomized phase II trial of a single early intravesical instillation of pirarubicin (THP) in the prevention of bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma: the THP Monotherapy Study Group Trial. J Clin Oncol. 2013;31:1422. Go to original source... Go to PubMed...
- Chiancone F, Fabiano M, Fedelini M, et al. Outcomes and complications of Hyperthermic IntraVesical Chemotherapy using mitomycin C or epirubicin for patiens with non‑muscle invasive bladder cancer after bacillus Calmette‑Guérin treatment silure. Cent European J Urol. 2020:73:287-294. Go to original source... Go to PubMed...
- Grimberg DC, Dudinec J, Shaha A, Inman BA. Clinical trial of high dose hyperthermic intravesical mitomycin C for intermediate and high‑risk non‑muscle invasive bladder cancer during BCG shortage. Urol Oncol. 2021;39:498. Go to original source... Go to PubMed...
- Liu K, Zhu J, Song Y, et al. Thermal Intravesical Chemotherapy Reduce Recurrence Rate for Non‑muscle Invesive Bladder Cancer patiens: A Meta‑Analysis. Front. Oncol. 2020;10:29. Go to original source... Go to PubMed...
- Plata A, Guerrero‑Ramos F, Garcia C, et al. Long‑Term Experience with Hypertermic Chemothera py (HIVEC) Using Mitomycin‑C in Patients with Non‑Muscle Invasive Bladder Cancer in Spain. J. Clin. Med. 2021;10:5105. Go to original source... Go to PubMed...