Immediate post-operative intravesical instillation of a single dose chemotherapy is not superior to continuous saline irrigation

TURKERI L., Karsiyakali N., Aslan G., Akgul M., Baltaci S., Bolat D., ...More

ACTAS UROLOGICAS ESPANOLAS, vol.46, no.8, pp.464-472, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 46 Issue: 8
  • Publication Date: 2022
  • Doi Number: 10.1016/j.acuro.2021.11.008
  • Journal Name: ACTAS UROLOGICAS ESPANOLAS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Gender Studies Database, MEDLINE, DIALNET
  • Page Numbers: pp.464-472
  • Keywords: Continuous saline bladder irrigation, Immediate postoperative instillation of intravesical chemotherapy, Intravesical chemotherapy, non-muscle-invasive bladder cancer, Transurethral resection of bladder tumors, T1 BLADDER-CANCER, TRANSURETHRAL RESECTION, STAGE TA, TUMOR, IMPLANTATION, METAANALYSIS, GEMCITABINE, PROGRESSION, EPIRUBICIN, INHIBITION
  • Dokuz Eylül University Affiliated: Yes

Abstract

Introduction and objectives: To evaluate whether there is any difference between immediate postoperative instillation of intravesical chemotherapy (IPOIC) and continuous saline bladder irrigation(CSBI) in terms of bladder cancer(BC) recurrence in patients with primary low-or intermediate-risk non-muscle-invasive BC (NMIBC).Materials and methods: Medical records of 1482 patients who underwent transurethral resec-tion of bladder tumor between March 1994 and August 2020 were reviewed retrospectively. Patients were divided into two groups according to IPOIC and/or CSBI administration status (Group 1: CSBI alone; Group 2: CSBI following IPOIC). Low-and intermediate-risk NMIBC patients were also divided into subgroups according to IPOIC and/or CSBI administration status. Results: A total of 594 patients with primary NMIBC were included. Of the patients, 86 (14.5%) were female and 508 (85.5%) were male with a median age of 69 (60-78) years. The frequency of patients in group 1 and group 2 were 361 (60.8%) and 233 (39.2%), respectively. Recurrent disease was observed in 213 (35.9%) patients. There was no difference between the groups when they were compared for recurrent disease frequency, median time to first recurrence and frequency of recurrence within first 12 months (P=.064, P=.671, and P=.145, respectively). Disease recurrence rates in low-risk NMIBC patients was lower when they were treated with "CSBI following IPOIC" when compared to "CSBI alone" (P=.042). However, no difference was observed in low-risk NMIBC subgroups when they were compared for pathological features of recurrent tumors such as number, size, grade, stage, and presence of carcinoma in situ (P>.05, for each).Conclusions: "CSBI following IPOIC" combination was not superior to "CSBI alone" for pre-venting adverse pathological outcomes in recurrent low-and intermediate-risk NMIBC.(c) 2022 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.