Department of Urology, Shiga University of Medical Science, Shiga, Japan;
Department of Urology, Shiga University of Medical Science, Shiga, Japan.
In Vivo. 2021 Mar-Apr;35(2):1141-1145. doi: 10.21873/invivo.12360.
This study evaluated the efficacy of a single instillation of pirarubicin with a short retention time for preventing intravesical recurrence of low-risk non-muscle-invasive bladder cancer.
We analyzed 165 patients with low-risk non-muscle-invasive bladder cancer who underwent transurethral surgery. Single instillation of pirarubicin with 15-min retention time immediate after surgery was performed in 47 (28%) patients. The other patients (118, 72%) were treated without instillation therapy. The primary endpoint was recurrence-free survival.
Median overall follow-up was 50 (range=6-134) months. Recurrence-free survival at 1 and 5 years was 91% and 72%, and 79% and 54% in the group treated with pirarubicin, and that treated with surgery alone, respectively (p=0.031). Cox's hazard analysis revealed lack of instillation and larger tumor size (>10 mm) as significant factors for risk of recurrence. No adverse events regarding intravesical chemotherapy were observed.
Pirarubicin instillation with 15-min retention time can prevent intravesical recurrence of low-risk bladder tumors.
本研究评估了短时间保留的吡柔比星单次灌注预防低危非肌层浸润性膀胱癌膀胱内复发的疗效。
我们分析了 165 例接受经尿道手术的低危非肌层浸润性膀胱癌患者。47 例（28%）患者术后即刻行吡柔比星 15 分钟保留时间的单次灌注。其他 118 例（72%）患者未行灌注治疗。主要终点为无复发生存。
中位总随访时间为 50 个月（范围 6-134）。吡柔比星组和单纯手术组的 1 年和 5 年无复发生存率分别为 91%和 72%、79%和 54%（p=0.031）。Cox 风险分析显示，缺乏灌注和肿瘤较大（>10mm）是复发风险的显著因素。未观察到与膀胱内化疗相关的不良事件。
短时间保留的吡柔比星灌注可预防低危膀胱肿瘤的膀胱内复发。
