Comparison of Three Schedules of Intravesical Epirubicin in Patients with Non–Muscle-Invasive Bladder Cancer

Hendricksen, Kees; Witjes, W.P.J.; Idema, J.G.; Kums, J.J.M.; Trip, Oncko B. van Vierssen; Bruin, M. J. F. M. de; Vergunst, H.; Caris, Christien; Janzing-Pastors, Maria H.D.; Witjes, J. Alfred

doi:10.1016/j.eururo.2007.12.033

Cited by 70 publications

(29 citation statements)

References 20 publications

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“…Oncogenesis was a diffuse ongoing process in the urothelium of these patients, and we believe that laser treatment cannot change the overall formation of new tumors. Although the establishment of the optimal treatment regimen for epirubicin is hampered by differences in dose, concentration, instillation schedule, frequency of instillation [12], the small size of some trials, post-operative instillation with epirubicin decreasesthe number of relapses after Ta/T1 bladder tumor resection [13]. Kuroda et al [12] randomized 622 patients with Ta-T1 G1-2 NMIBC for adjuvant treatment with 17doses of epirubicin 20 mg/40 ml in12 month, 12 doses of epirubicin 30 mg/40 ml in 7 month, or 9 doses epirubicin 40 mg/40 ml in 4 months.…”

Section: Discussionmentioning

confidence: 99%

2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin

et al. 2011

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Section: Discussionmentioning

confidence: 99%

2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin

et al. 2011

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“…Two trials [25,29] reported the methods which were central enrollment and telephone announcement, so were judged as "low risk of bias". The trial by Hendricksen in 2008 [28] was still judged as "high risk of allocation bias" for the similar reason, in which the allocation concealment was difficult to achieve during the course of grouping by the date of TURBT ( fig. 1B).…”

Section: Risk Of Bias In Included Studies 231 Allocation (Selectionmentioning

confidence: 98%

“…We only included the two groups with the start regimen of one immediate instillation in a trial by Mitsumori in 2004, because the duration of the other two groups with the start regimen of delayed instillations was similar. In the trial by Hendricksen in 2008 [28] , 2 short-term groups separately started with one immediate instillation and delayed instillations; and the long-term group started with delayed instillations. We chose the short-term group started with delayed instillations for comparison because the schedules of the two short-term groups were the same.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Long-term versus short-term introvesical chemotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis of the published results of randomized clinical trials

Teng

Xing

Liu

et al. 2014

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

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“…It should be given within 24 h, as prevention of tumor cell implantation is only effective within the first hours after cell seeding [20]. No prospective data are available showing that the single instillation significantly reduces recurrence rates in patients with recurrent tumors.…”

Section: Discussionmentioning

confidence: 99%

Extravasation of Intravesical Chemotherapy for Non-Muscle-Invasive Bladder Cancer

Mertens¹,

Meinhardt²,

Rier³

et al. 2012

Urol Int

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Purpose: To report our experience with symptomatic extravasation of intravesical chemotherapy administered within 24 h after transurethral resection (TUR) over the past 10 years. Methods: We identified all consecutive patients who presented with symptomatic extravasation of intravesical chemotherapy following TUR between 2001 and 2011. We assessed the severity of the postoperative complications using the modified Clavien system. Results: We identified 9 patients (mean age 59, range 40–76 years) with symptomatic extravasation. One patient had grade II, 2 had grade IIIa, and 5 patients had grade IIIb complications according to the Clavien system. Surgery was needed in 6 of 9 patients. One required ICU management (Clavien IV). No patients died in the postoperative course. Conclusion: Extravasation can cause severe complications and diagnosis is often protracted. Considering the growing practice of immediate intravesical instillations, the number of patients with symptomatic extravasation is expected to rise. An increased awareness of this possible complication is warranted.

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Comparison of Three Schedules of Intravesical Epirubicin in Patients with Non–Muscle-Invasive Bladder Cancer

Cited by 70 publications

References 20 publications

2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin

2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin

Long-term versus short-term introvesical chemotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis of the published results of randomized clinical trials

Extravasation of Intravesical Chemotherapy for Non-Muscle-Invasive Bladder Cancer

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