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Tan WP, Bello AP, Garcia Alvarez C, Guerrero-Ramos F, González-Padilla DA, Nzeh C, Manuel de la Morena J, de Torres IGV, Hendricksen K, Díaz Goizueta FJ, Del Alamo FJ, Chiancone F, Fedelini P, Poggio M, Porpiglia F, Gonzalo Rodríguez VC, Torres JM, Wilby D, Robinson R, Sousa-Escandón A, Mata JL, Moreno JLP, Molina FD, Semino MAA, Stemberger AT, Calleja-Escudero J, Redorta JP, Tan WS. A Multicenter Study of 2-year Outcomes Following Hyperthermia Therapy with Mitomycin C in Treating Non-Muscle Invasive Bladder Cancer: HIVEC-E. Bladder Cancer 2022. [DOI: 10.3233/blc-220026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION: High grade, non-muscle invasive bladder cancer (NMIBC) is treated with intravesical Bacillus Calmette–Guérin. Chemohyperthermia therapy (CHT) may be a novel alternative therapy for the treatment of NMIBC. OBJECTIVE: To evaluate the recurrence-free survival (RFS) of patients treated with CHT using the Combat bladder recirculation system (BRS) for NMIBC. METHODS: This was a prospective multi-institutional study of 1,028 consecutive patients with NMIBC undergoing CHT between 2012 and 2020. A total of 835 patients were treated with CHT and Mitomycin C (MMC). Disease was confirmed on transurethral resection of bladder tumor (TURBT). Patients with NMIBC underwent CHT with MMC. Follow-up included cystoscopy and subsequent TURBT if recurrence/progression was suspected. The primary endpoint was RFS. Secondary endpoints were progression-free survival (PFS) and adverse events from CHT. RESULTS AND LIMITATIONS: Median follow up was 22.4 months (Interquartile range (IQR): 12.8 –35.8). Median age was 70.4 years (IQR: 62.1 –78.6). A total of 557 (66.7%), 172 (20.6) and 74 (8.9%) of patients were classified to BCG naïve, BCG unresponsive and BCG refractory/relapsing/intolerant, respectively. The RFS at 12 months and 24 months for BCG naïve was 87.6% (95% CI 85.0% - 90.4%) and 75.0% (95% CI 71.3% - 78.8%), respectively. The RFS at 12 months and 24 months for BCG unresponsive cohort was 78.1% (95% CI 72.0% - 84.7%) and 57.4% (95% CI 49.7% - 66.3%), respectively. The RFS at 24 months for the BCG unresponsive cohort for CIS positive and CIS negative patients were 43.6% (95% CI 31.4% –60.4%) and 64.5% (95% CI 55.4% - 75.1%), respectively. Minor events occurred in 216 (25.6%) of patients and severe events occurred in 17 (2.0%). CONCLUSIONS: CHT with MMC using the Combat BRS is effective in the medium term and has a favorable adverse event profile.
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Affiliation(s)
| | - Ana Plata Bello
- Department of Urology, Hospital Universitario de Canarias, Canary Islands, Spain
| | | | | | | | | | | | | | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | | | | | | | | | | | | | - Daniel Wilby
- Department of Urology, Queen Alexandra Hospital, Portsmouth, UK
| | | | | | | | | | | | | | | | | | - Joan Palou Redorta
- Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - Wei Shen Tan
- Department of Uro-oncology, University College London Hospital, London, UK
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