Maintenance therapy for superficial bladder cancer

Transurethral resection remains the standard for first-line treatment of tr ansitional cell carcinoma of the bladder This technique clearly defines the pathologic grade and is essential in determining the clinical stage of the bladder tumor. Intravesical therapy is ail important adjunct to transureth ral resection in the management of patients with superficial bladder cancer , many of whom are at risk for disease recurrence and progression. Pharmaco therapy consisting of cytotoxic and immunomodulating agents has demonstrate d utility against superficial transitional cell carcinoma. Bacillus Calmett e-Guerin and mitomycin (Mutamycin) remain the more commonly used and most e ffective agents in the prophylaxis against recurrence and progression of su perficial bladder transitional cell carcinoma. Many studies have examined t heir efficacy at different schedules. This article reviews the traditional intravesical agents that are useful in the therapy and prophylaxis of super ficial transitional cell carcinoma of the bladder. It also addresses their long-term efficacy when used as maintenance therapy in higher-risk patients .