Maintenance therapy for superficial bladder cancer.
Transurethral resection remains the standard for first-line treatment of transitional cell carcinoma of the bladder. This technique clearly defines the pathologic grade and is essential in determining the clinical stage of the bladder tumor. Intravesical therapy is an important adjunct to transurethral resection in the management of patients with superficial bladder cancer, many of whom are at risk for disease recurrence and progression. Pharmacotherapy consisting of cytotoxic and immunomodulating agents has demonstrated utility against superficial transitional cell carcinoma. Bacillus Calmette-Guérin and mitomycin (Mutamycin) remain the more commonly used and most effective agents in the prophylaxis against recurrence and progression of superficial bladder transitional cell carcinoma. Many studies have examined their efficacy at different schedules. This article reviews the traditional intravesical agents that are useful in the therapy and prophylaxis of superficial transitional cell carcinoma of the bladder. It also addresses their long-term efficacy when used as maintenance therapy in higher-risk patients.
Department of Urology, Temple University Hospital, Philadelphia, Pennsylvania, USA.
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Baselli
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Greenberg
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001500:BCG Vaccine / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D003131:Combined Modality Therapy; D006801:Humans; D016685:Mitomycin / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013520:Urologic Surgical Procedures
D000903:Antibiotics, Antineoplastic; D001500:BCG Vaccine; D016685:Mitomycin