Analysis of Japanese Patients Treated with or without Long-Term Epirubicin Plus Ara-C Intravesical Instillation Therapy for Low-Grade Superficial Bladder Cancer

Abstract EN

The high incidence of tumor recurrence following transurethral resection (TUR) represents a major problem encountered in the management of bladder cancer.

This study examined the efficacy of intravesical chemotherapy in superficial bladder cancer.

We retrospectively analyzed 90 Japanese cases with low-grade superficial transitional cell carcinoma (stage T1, grades 1 and 2) who were rendered tumor-free by TURBT (TUR of bladder tumor) and who thereafter were treated with or without intravesical chemotherapy.

Among them, instillation was terminated in 2 patients due to adverse effects (severe but reversible chemical cystitis).

Remaining 88 patients were divided into 2 groups according to therapy: the TURBT-only group (n=46), defined as patients treated with TURBT alone, and the Instillation group (n=42), defined as patients treated with weekly intravesical instillation therapies using epirubicin plus Ara-C.

Recurrence-free rate was significantly higher in the Instillation group than in the TURBT-only group (p=0.02, HR = 0.457).

The 5-year recurrence-free rate was 58.5% for the Instillation group and 38.6% for the TURBT-only group.

Our instillation schedule represents the most intensive regimen among previously reported therapies and resulted in a 54.3% decrease in incidence of tumor recurrence.

We believe that the results of this study could provide useful information on management of bladder cancer.