The use of valrubicin for the chemoresection of superficial bladder cancer- A marker lesion study

Objectives: To assess the effect and tolerance of a 6-week course of intrav esical valrubicin on a tumour intentionally left in the bladder (marker les ion) following incomplete transurethral resection of the bladder (TURBT). Patients and Methods: In a prospective phase II study, 40 patients with ref ractory superficial transitional cell carcinoma (TCC), with or without carc inoma in situ, underwent TURBT at which a tumour < 1 cm in diameter was del iberately left in the bladder. They were then treated with six instillation s of 800 mg valrubicin at weekly intervals. Patients were assessed three mo nths after the initial TURBT by cystoscopy and biopsy. Patients remaining c lear of disease underwent repeat cystoscopies at 3-monthly intervals until recurrence or for up 2 years. Results: 21/39 (54%) of patients were found to be clinically clear of disea se upon cystoscopic examination at 3 months. 18/39 (46%) of patients were c onsidered histologically clear of bladder disease. The current estimate of the mean time to recurrence is 248 days. Conclusions: A 6-week course of intravesical valrubicin has proved effectiv e in ablating a marker tumour left in the bladder after incomplete TURBT an d in preventing or delaying recurrence of further tumours in a group of pat ients with previously treated superficial TCC. Copyright (C) 2001 S. Karger AG, Basel.