Intravesical radiofrequency-induced chemohyperthermia for carcinoma in situ of the urinary bladder: A retrospective multicentre study
van Valenberg, FJP, Kajtazovic, A, Canepa, G, Lüdecke, G, Kilb, JI, Aben, KKH, Nativ, O, Madaan, S, Ayres, B, Issa, R and Witjes, JA 2018. Intravesical radiofrequency-induced chemohyperthermia for carcinoma in situ of the urinary bladder: A retrospective multicentre study. Bladder Cancer. 4 (4), pp. 365-376. https://doi.org/10.3233/BLC-180187
|Authors||van Valenberg, FJP, Kajtazovic, A, Canepa, G, Lüdecke, G, Kilb, JI, Aben, KKH, Nativ, O, Madaan, S, Ayres, B, Issa, R and Witjes, JA|
Objective:To examine the effect of intravesical radiofrequency-induced chemohyperthermia (RF-CHT) in carcinoma in-situ (CIS) patients overall and split according to previously received therapy.
Methods:CIS patients that underwent an induction and maintenance phase of≥6 RF-CHT instillations, and had either pathology or cystoscopy plus cytology available at 6 months of follow-up were retrospectively included. Complete response (CR), recurrences, cystectomy-free rate, overall survival (OS), and adverse events were evaluated. Analysis was performed for overall, bacillus Calmette-Guérin (BCG)-unresponsive, other BCG-treated, and treatment naïve patients.
Results:Patients (n = 150) had a mean of 17.5, 9.2, or 0 previous BCG instillations in the BCG-unresponsive (n = 50), other BCG-treated (n = 46, missing n = 4), and treatment naïve groups (n = 47, missing n = 3), respectively. After 6 months, a CR of 46.0%, 71.7%, and 83.0% was found (p < 0.001). Subsequent 2-year recurrence rates were 17.4%, 27.3%, and 12.8%, respectively. The overall cystectomy-free rate and OS at mean follow-up (35.8 months) were 78.5% and 78.0%, respectively. These were 71.4% vs. 84.1% vs. 86.7% (cystectomy-free rate, p = 0.006) and 76.0% vs. 69.6% vs. 87.2% (OS, p = 0.06) for BCG-unresponsive vs. other BCG-treated vs. treatment naïve patients. Progression to muscle-invasive disease was seen in 13.3% of patients. Patients stopped induction or maintenance RF-CHT instillations due to adverse events in respectively 13.4% and 17.8%.
Conclusions:Intravesical RF-CHT showed good results in both treatment naïve and BCG-treated CIS patients, avoiding the need for cystectomy in 78.5% of cases for at least 3 years with a modest risk of progression. Thus, RF-CHT proves an alternative to cystectomy in selected high-risk patients
|Keywords||Hyperthermia; Radiofrequency; Urinary bladder neoplasms; Intravesical therapy; Carcinoma in situ; Bacillus Calmette-Guérin|
|Journal citation||4 (4), pp. 365-376|
|Digital Object Identifier (DOI)||https://doi.org/10.3233/BLC-180187|
|Online||11 Sep 2018|
|Publication process dates|
|Accepted||07 Aug 2018|
|Deposited||25 Nov 2021|
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