Up-Front Intravesical Chemotherapy for Low Stage, Low Grade Recurrent Bladder Cancer

Purpose

We evaluated the ablative and prophylactic potential of short schedule, up-front topical chemotherapy on low stage and grade recurrent bladder tumors.

Materials and Methods

The study design consisted of 4 weekly instillations followed by transurethral resection during week 5. Mitomycin C was administered initially and mitoxantrone was administered following the same schedule if disease recurred during followup.

Results

After up-front mitomycin C, 29 of 42 patients (69 percent) has a complete response with no need for transurethral resection, whereas residual disease was resected in the remaining 13 (31 percent). Disease recurred during followup in 22 of the 42 patients (52.4 percent), who were then treated with up-front mitoxantrone with a complete response in 14 (63.7 percent). Residual disease was resected in 8 patients (36.3 percent) with progression to grade 3 in 2.

Conclusions

Short schedule intravesical chemotherapy can completely ablate small volume recurrent superficial bladder cancer in a relevant number of patients but it is not adequate prophylaxis.