Results of Intravesical Chemo-Hyperthermia in High-risk Non-muscle Invasive Bladder Cancer


Purpose: To examine the effectiveness of mitomycin-C and chemo-hyperthermia in combination for patientswith high-risk non-muscle-invasive bladder cancer. Materials and
Methods: Between November 2011-September2013, 43 patients with high-risk non-muscle-invasive bladder cancer undergoing adjuvant chemo-hyperthermiain 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 factorsincluded age, gender, smoking status, AB0 blood group, body mass index, T stage and grade, concominant CISassets. The associations between predictors and recurrence were assessed using multivariate Cox proportionalhazard analyses.
Results: A total of 40 patients completed induction therapy. Thirteen (32.5%) were diagnosedwith tumor recurrence. Median follow-up was 30 months (range 9-39). Median recurrence-free survival was23 months (range 6-36). The Kaplan-Meier-estimated recurrence-free rates for the entire group at 12 and 24months were 82% and 61%. There was no statistically significant difference between patient subgroups. Coxhazard analyses showed that an A blood type (OR=6.23, p=0.031) was an independent predictor of recurrencefree.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 inhigh-risk patients with non-muscle-invasive bladder cancer who cannot tolerate or have contraindications forstandard BCG therapy.