When medical evidence alone is simply not enough

O’Donnell, Michael A.

doi:10.1002/cncr.24312

Cited by 2 publications

(3 citation statements)

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“…Continuous bladder irrigation with saline solution and improved TURBT techniques were postulated to underlie the low recurrence rate. 13 Our fi ndings reject the continuous bladder irrigation hypothesis, because all patients received continuous bladder irrigation with saline solution after TURBT for 8-18 h. The role of early intravesical instillation of chemotherapy after TURBT with fl uorescence cystoscopy has not been established. However, even if disease detection and resection completeness are improved, 2 the risk of tumour-cell seeding remains.…”

Section: Discussioncontrasting

confidence: 56%

“…However, disagreement persists despite level 1 evidence supporting its use, [8][9][10][11][12] and it is rarely given by urologists. 13 In laboratory 14 and clinical studies, 15 intravesical electromotive drug administration (EMDA) increased mitomycin bladder uptake, improving clinical effi cacy in high-risk non-muscle invasive bladder cancer. Intravesical EMDA mitomycin is not recommended immediately after TURBT because catheter electrode rigidity might cause additional mechanical trauma and urothelial injury, leading to bladder spasm and leakage of drug solution.…”

Section: Introductionmentioning

confidence: 99%

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Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Stasi

Valenti

Verri

et al. 2011

The Lancet Oncology

122

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SummaryBackground The clinical eff ect of intravesical instillation of chemotherapy immediately after transurethral resection of bladder tumours (TURBT) has recently been questioned, despite its recommendation in guide lines. Our aim was to compare TURBT alone with immediate post-TURBT intravesical passive diff usion (PD) of mitomycin and immediate pre-TURBT intravesical electromotive drug administration (EMDA) of mitomycin in non-muscle invasive bladder cancer.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Stasi

Valenti

Verri

et al. 2011

The Lancet Oncology

122

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“…Una meta-analisi dell'European Organisation for Research and Treatment of Cancer (EORTC) ha dimostrato che una singola dose di chemioterapia intravescicale somministrata poche ore dopo la TURBT determina una riduzione significativa della recidiva nei pazienti con TVNIM a rischio basso e intermedio (7). Tuttavia, nonostante il livello 1 di evidenza, che ne giustifica un'ampia utilizzazione, questo approccio terapeutico è oggetto di controversie (8–12) e raramente è praticato dagli urologi (13).…”

Section: Introduzioneunclassified

Intravesical Therapy with Mitomycin through Electromotive Drug Administration

et al. 2013

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Intravesical therapy with Mitomycin through Electromotive Drug Administration In the management of non-muscle invasive bladder cancer (NMIBC), high-level evidence supports the widespread practice of intravesical therapy with mitomycin-C (MMC). Randomized trials showed a significant reduction in short-term recurrence compared with transurethral resection of bladder tumor (TURBT) alone, but little effect on long-term and no impact at all in preventing progression. Electromotive drug administration (EMDA®) offers a means of controlling and enhancing the tissue transport of certain drugs, in order to increase their efficacy. In both laboratory and clinical studies, intravesical electromotive drug administration (EMDA) increases MMC bladder uptake, resulting in an improved Accepted: June 20, 2013 ORIGINAL ARTICLE Tis) (2). La resezione trans-uretrale delle neoplasie della vescica (TURBT) costituisce lo step iniziale della gestione di questa malattia e rappresenta un trattamento efficace e uno strumento essenziale per la diagnosi e la stadiazione patologica. Nonostante l'utilizzo di terapie intravescicali adiuvanti dopo TURBT, queste neoplasie mostrano a 5 anni tassi di recidiva e progressione della malattia rispettivamente del 31-78% e dell'1-45% (3). Le ripetute TURBT e terapie intravescicali, sono spesso causa di effetti indesiderati e complicanze e rendono il trattamento del tumore della vescica, dalla diagnosi al decesso del paziente, il più costoso tra i trattamenti dei tumori maligni (4). Il concetto

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When medical evidence alone is simply not enough

Cited by 2 publications

References 50 publications

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Electromotive instillation of mitomycin immediately before transurethral resection for patients with primary urothelial non-muscle invasive bladder cancer: a randomised controlled trial

Intravesical Therapy with Mitomycin through Electromotive Drug Administration

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