INTRAVESICAL ADJUVANT CHEMOTHERAPY FOR SUPERFICIAL TRANSITIONAL-CELL BLADDER-CARCINOMA - RESULTS OF 2 -ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER RANDOMIZED TRIALS WITH MITOMYCIN-C AND DOXORUBICIN COMPARING EARLY VERSUS DELAYED INSTILLATIONS AND SHORT-TERM VERSUS LONG-TERM TREATMENT

The European Organization for Research and Treatment of Cancer genitou rinary group has completed 2 parallel prospective randomized studies, one with 30 mg. mitomycin C and the other with 50 mg. doxorubicin as a djuvant intravesical treatment after transurethral resection of superf icial transitional cell bladder carcinoma. These studies were designed to compare early (the day of resection) versus delayed (between 7 and 15 days after resection) instillations and short-term (6 months) vers us long-term (12 months) treatment. The results indicate that in regar d to recurrence rate patients having a delayed and short-term treatmen t; do worse than those having early instillations (for 6 or 12 months) or those having prolonged treatment (either immediate or delayed). Wi th an average followup of 4 years survival, progression beyond T1 dise ase, development of distant metastases and appearance of a second prim ary were not influenced by the therapeutic regimen. A multivariate ana lysis of prognostic factors is presented, which indicates that after a djustment for these factors, patients in the delay, no maintenance arm have a significantly higher recurrence rate than the other patients.