Carando Roberto, Soldini Emiliano, Cotrufo Simone, Zazzara Michele, Ludovico Giuseppe M
Klinik für Urologie, Luzerner Kantonsspital, Luzern, Switzerland.
Clinica Luganese Moncucco, Lugano, Switzerland.
Arab J Urol. 2020 Aug 31;19(1):71-77. doi: 10.1080/2090598X.2020.1816150.
To evaluate the effectiveness of electro-mediated drug administration of mitomycin C (EMDA/MMC) after transurethral resection of the bladder tumour (TURBT) in preventing non-muscle-invasive bladder cancer (NMIBC) recurrence and progression and to explore clinical and demographic factors associated with treatment response.
Between April 2016 and August 2019, 112 patients diagnosed with intermediate- or high-risk NMIBC underwent a TURBT followed by an EMDA/MMC treatment. The percentage of treatment responders and progression-free survivors at 3 and 6 months were evaluated.
Follow-up data were available for 101 patients (90%) at 3 months and 92 (82%) at 6 months. Response rates to EMDA/MMC treatment were 85% at 3 months and 75% at 6 months, and progression-free rates were 94% and 90%, respectively. No statistically significant differences were seen between intermediate- and high-risk patients. A higher risk of tumour recurrence and progression was associated with previous Bacillus Calmette-Guérin (BCG) failure. According to the Clavien-Dindo classification, only low-grade complications were observed.
EMDA/MMC after TURBT was associated with high response and progression-free rates at 3 and 6 months, with only low-grade adverse events. These results confirm the efficacy and safety of EMDA/MMC as a therapeutic option for both intermediate- and high-risk patients. However, patients with BCG failure responded poorly to EMDA/MMC.: ACCI: age-adjusted Charlson Comorbidity Index; CHT: chemohyperthermia; CIS: carcinoma ; EMDA: electro-mediated drug administration; EORTC: European Organisation for Research and Treatment of Cancer; IQR: interquartile range; (N)MIBC: (non-)muscle-invasive bladder cancer; MMC: mitomycin C; OR, odds ratio; TURBT: transurethral resection of the bladder tumour.
评估经尿道膀胱肿瘤切除术(TURBT)后丝裂霉素C电介导药物给药(EMDA/MMC)预防非肌层浸润性膀胱癌(NMIBC)复发和进展的有效性,并探讨与治疗反应相关的临床和人口统计学因素。
2016年4月至2019年8月期间,112例诊断为中高危NMIBC的患者接受了TURBT,随后进行了EMDA/MMC治疗。评估了3个月和6个月时治疗反应者和无进展幸存者的百分比。
3个月时101例患者(90%)、6个月时92例患者(82%)有随访数据。EMDA/MMC治疗的缓解率3个月时为85%,6个月时为75%,无进展率分别为94%和90%。中高危患者之间未见统计学显著差异。既往卡介苗(BCG)治疗失败与肿瘤复发和进展风险较高相关。根据Clavien-Dindo分类,仅观察到低级别并发症。
TURBT后EMDA/MMC在3个月和6个月时具有高缓解率和无进展率,仅伴有低级别不良事件。这些结果证实了EMDA/MMC作为中高危患者治疗选择的有效性和安全性。然而,BCG治疗失败的患者对EMDA/MMC反应较差。:ACCI:年龄调整的Charlson合并症指数;CHT:化学热疗;CIS:癌;EMDA:电介导药物给药;EORTC:欧洲癌症研究与治疗组织;IQR:四分位间距;(N)MIBC:(非)肌层浸润性膀胱癌;MMC:丝裂霉素C;OR:比值比;TURBT:经尿道膀胱肿瘤切除术