The optimal intravesical maintenance chemotherapy scheme for the intermediate-risk group non-muscle-invasive bladder cancer

BMC Cancer

Research

Wen-Ting Huang¹  Yuan-Liang Xie²  Rui Lin²  Qing-Yun Zhang²  Cheng-En Deng²  Hao-Yuan Lu²  Jue-ling Wei²  Guan-Zheng Feng²  Guang-Lin Yang²  Jun Long³  Zeng-nan Mo⁴  Jian-Xin Chen⁵ 

[1] Department of Nursing, Guangxi Health Science College, 530021, Nanning, Guangxi, China;Department of Urology, Affiliated Tumour Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China;Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China;Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China;Center for Genomic and Personalized Medicine, Guangxi key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, 530021, Nanning, Guangxi, China;Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China;Department of Urology, Affiliated Tumour Hospital of Guangxi Medical University, 530021, Nanning, Guangxi, China;Center for Genomic and Personalized Medicine, Guangxi key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, 530021, Nanning, Guangxi, China;

关键词: Non-muscle-invasive Bladder cancer;    Intravesical chemotherapy;    Pirrubicin;    Tumor recurrence;   

DOI  :  10.1186/s12885-023-11523-9

 received in 2023-03-18, accepted in 2023-10-13,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveAlthough the current European Association of Urology(EAU) guideline recommends that patients with intermediate-risk non-muscle-invasive bladder cancer (NMIBC) should accept intravesical chemotherapy or Calmette-Guerin (BCG) for no more than one year after transurethral resection of bladder tumor(TURBT), there is no consensus on the optimal duration of chemotherapy. Hence, we explored the optimal duration of maintenance intravesical chemotherapy in patients with intermediate-risk NMIBC.Subjects and MethodsThis was a real-world single-center retrospective cohort study. In total 158 patients with pathologically confirmed intermediate-risk NMIBC were included, who were divided into 4 subgroups based on the number of instillations given. We used Cox regression analysis and survival analysis chart to explore the 3-yr recurrence outcomes of tumor.The optimal duration was determined by receive operating characteristic curve (ROC).ResultsThe median follow-up was 5.2 years. Compared with instillation for 1–2 months, the Hazard Ratios(HR) values of instillation for less than 1 month, maintenance instillation for 3–6 months and > 6 months were 3.57、1.57 and 0.22(95% CI 1.27–12.41;0.26–9.28;0.07–0.80, P = 0.03;0.62;0.02, respectively). We found a significant improvement in 3-yr relapse-free survival in intermediate-risk NMIBC patients who maintained intravesical instillation chemotherapy for longer than 6 months, and the best benefit was achieved with 10.5 months of maintenance chemotherapy by ROC.ConclusionsIn our scheme, the optimal duration of intravesical instillation with pirrubicin is 10.5 months. This new understanding provides valuable experience for the precise medical treatment model of intermediate-risk NMIBC.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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