Results of Intravesical Chemo-Hyperthermia in High-risk Non-muscle Invasive Bladder Cancer.
OBJECTIVE
To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patients with high-risk non-muscle-invasive bladder cancer.


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.
Department of Urology, Tepecik Teaching and Research Hospital, Izmir, Turkey E-mail : gokhanekin@gmail.com.
Rahmi Gokhan
RG
Ekin
Ilker
I
Akarken
Ozgur
O
Cakmak
Huseyin
H
Tarhan
Orcun
O
Celik
Yusuf Ozlem
YO
Ilbey
Rauf Taner
RT
Divrik
Ferruh
F
Zorlu
D000017:ABO Blood-Group System; D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000453:epidemiology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000453:epidemiology / Q000628:therapy*
D000017:ABO Blood-Group System; D000903:Antibiotics, Antineoplastic; D016685:Mitomycin