title: Thermochemotherapy for non-muscle-invasive bladder cancer: is there a chance to avoid early cystectomy?.
abstract: OBJECTIVE
  Non-muscle-invasive bladder cancer is characterized by a high recurrence rate after primary transurethral resection. In case of bacillus Calmette-Guérin-refractory neoplasms, cystectomy is the gold standard. In this study the effects of thermochemotherapy with mitomycin C were evaluated in high-risk bladder cancer nonresponders to previous therapy.
  
  
  METHODS
  Between January 2006 and December 2009, 30 patients were enrolled with recurrent stage carcinoma in situ, Ta and T1, grade G1 to G3 non-muscle-invasive bladder cancer refractory to chemotherapy or immunotherapy and so becoming suitable for radical cystectomy. All patients underwent endovesical thermochemotherapy: 16 patients underwent a prophylactic scheme and 14 patients underwent an ablative scheme.
  
  
  RESULTS
  All the patients completed the study. The mean follow-up for all the patients enrolled was 14 months. Thirteen of 30 patients (43.30%) were disease free and 17 patients (56.70%) had recurrence. In the prophylactic group, 7 of 16 patients (43.75%) were disease free and 9 patients (46.25%) had tumor recurrence; no progression was observed. In the ablative group, 3 patients (17, 64%) had progression to muscle-invasive disease. Side effects were generally mild.
  
  
  CONCLUSIONS
  Thermochemotherapy could be considered an additional tool in patients refractory to intravesical therapies before considering early cystectomy.
authors.affiliation: Department of Urology, Catholic University of the Sacred Heart, Rome, Italy. dr.avolpe@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Volpe
authors.forename: M
authors.initials: M
authors.lastname: Racioppi
authors.forename: L
authors.initials: L
authors.lastname: Bongiovanni
authors.forename: D
authors.initials: D
authors.lastname: D'Agostino
authors.forename: A
authors.initials: A
authors.lastname: Totaro
authors.forename: A
authors.initials: A
authors.lastname: D'Addessi
authors.forename: F
authors.initials: F
authors.lastname: Marangi
authors.forename: G
authors.initials: G
authors.lastname: Palermo
authors.forename: F
authors.initials: F
authors.lastname: Pinto
authors.forename: E
authors.initials: E
authors.lastname: Sacco
authors.forename: P F
authors.initials: PF
authors.lastname: Bassi
mesh_terms: D015653:Cystectomy / Q000379:methods; D003558:Cystoscopy / Q000379:methods; D018450:Disease Progression; D018572:Disease-Free Survival; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D012008:Recurrence; D012306:Risk; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*; D014572:Urology / Q000379:methods*