Journalartikel

Jahr der Veröffentlichung: 2018

Seiten: 365-376

Zeitschrift: Bladder cancer

Bandnummer: 4

Heftnummer: 4

ISSN: 2352-3727

eISSN: 2352-3735

Open Access Status: Green

DOI Link: https://doi.org/10.3233/BLC-180187

Verlag: SAGE Publications

Abstract: 

Objective: To examine the effect of intravesical radiofrequency-induced chemohyperthermia (RF-CHT) in carcinoma in-situ (CIS) patients overall and split according to previously received therapy.

Methods: CIS patients that underwent an induction and maintenance phase of >= 6 RF-CHT instillations, and had either pathology or cystoscopy plus cytology available at 6 months of follow-up were retrospectively included. Complete response (CR), recurrences, cystectomy-free rate, overall survival (OS), and adverse events were evaluated. Analysis was performed for overall, bacillus Calmette-Guerin (BCG)-unresponsive, other BCG-treated, and treatment naive patients.

Results: Patients (n=150) had a mean of 17.5, 9.2, or 0 previous BCG instillations in the BCG-unresponsive (n = 50), other BCG-treated (n= 46, missing n= 4), and treatment naive groups (n= 47, missing n=3), respectively. After 6 months, a CR of 46.0%, 71.7%, and 83.0% was found (p <0.001). Subsequent 2-year recurrence rates were 17.4%, 27.3%, and 12.8%, respectively. The overall cystectomy-free rate and OS at mean follow-up (35.8 months) were 78.5% and 78.0%, respectively. These were 71.4% vs. 84.1% vs. 86.7% (cystectomy-free rate, p =0.006) and 76.0% vs. 69.6% vs. 87.2% (OS, p= 0.06) for BCG-unresponsive vs. other BCG-treated vs. treatment naive patients. Progression to muscle-invasive disease was seen in 13.3% of patients. Patients stopped induction or maintenance RF-CHT instillations due to adverse events in respectively 13.4% and 17.8%.

Conclusions: Intravesical RF-CHT showed good results in both treatment naive and BCG-treated CIS patients, avoiding the need for cystectomy in 78.5% of cases for at least 3 years with a modest risk of progression. Thus, RF-CHT proves an alternative to cystectomy in selected high-risk patients.

Harvard-Zitierstil: van Valenberg, F., Kajtazovic, A., Canepa, G., Luedecke, G., Kilb, J., Aben, K., et al. (2018) Intravesical Radiofrequency-Induced Chemohyperthermia for Carcinoma in Situ of the Urinary Bladder: A Retrospective Multicentre Study, Bladder cancer, 4(4), pp. 365-376. https://doi.org/10.3233/BLC-180187

APA-Zitierstil: van Valenberg, F., Kajtazovic, A., Canepa, G., Luedecke, G., Kilb, J., Aben, K., Nativ, O., Madaan, S., Ayres, B., Issa, R., & Witjes, J. (2018). Intravesical Radiofrequency-Induced Chemohyperthermia for Carcinoma in Situ of the Urinary Bladder: A Retrospective Multicentre Study. Bladder cancer. 4(4), 365-376. https://doi.org/10.3233/BLC-180187