UP-FRONT INTRAVESICAL CHEMOTHERAPY FOR LOW STAGE, LOW-GRADE RECURRENTBLADDER-CANCER

Purpose: We evaluated the ablative and prophylactic potential of short schedule, up-front topical chemotherapy on low stage and grade recurr ent bladder tumors. Materials and Methods: The study design consisted of 4 weekly instillations followed by transurethral resection during w eek 5. Mitomycin C was administered initially and mitoxantrone was adm inistered following the same schedule if disease recurred during follo wup. Results: After up-front mitomycin C, 29 of 42 patients (69%) had a complete response with no need for transurethral resection, whereas residual disease was resected in the remaining 13 (31%), Disease recur red during followup in 22 of the 42 patients (52.4%), who were then tr eated with up-front mitoxantrone with a complete response in 14 (63.7% ). Residual disease was resected in 8 patients (36.3%) with progressio n to grade 3 in 2. Conclusions: Short schedule intravesical chemothera py can completely ablate small volume recurrent superficial bladder ca ncer in a relevant number of patients but it is not adequate prophylax is.