Department of Urology, Acibadem M.A. Aydinlar University, Altunizade Hospital, Istanbul, Turkey.
Department of Urology, Acibadem M.A. Aydinlar University, Altunizade Hospital, Istanbul, Turkey.
Actas Urol Esp (Engl Ed). 2022 Oct;46(8):464-472. doi: 10.1016/j.acuroe.2021.11.007. Epub 2022 Sep 9.
To evaluate whether there is any difference between immediate postoperative instillation of intravesical chemotherapy (IPOIC) and continuous saline bladder irrigation (CSBI) in terms of bladder cancer (BC) recurrence in patients with primary low- or intermediate-risk non-muscle-invasive BC (NMIBC).
Medical records of 1482 patients who underwent transurethral resection of bladder tumor between March 1994 and August 2020 were reviewed retrospectively. Patients were divided into two groups according to IPOIC and/or CSBI administration status [Group-1 = CSBI alone; Group-2 = CSBI following IPOIC]. Low- and intermediate-risk NMIBC patients were also divided into subgroups according to IPOIC and/or CSBI administration status.
A total of 594 patients with primary NMIBC were included. Of the patients, 86 (14.5%) were female and 508 (85.5%) were male with a median age of 69 (60-78) years. The frequency of patients in Group-1 and Group-2 were 361 (60.8%) and 233 (39.2%), respectively. Recurrent disease was observed in 213 (35.9%) patients. There was no difference between the groups when they were compared for recurrent disease frequency, median time to first recurrence and frequency of recurrence within first 12 months (P = .064, P = .671, and P = .145, respectively). Disease recurrence rates in low-risk NMIBC patients was lower when they were treated with "CSBI following IPOIC" when compared to "CSBI alone" (P = .042). However, no difference was observed in low-risk NMIBC subgroups when they were compared for pathological features of recurrent tumors such as number, size, grade, stage, and presence of carcinoma in situ (P > .05, for each).
"CSBI following IPOIC" combination was not superior to "CSBI alone" for preventing adverse pathological outcomes in recurrent low- and intermediate-risk NMIBC.
评估原发性低危或中危非肌层浸润性膀胱癌（NMIBC）患者中，即刻膀胱内化疗（IPOIC）与持续生理盐水膀胱灌洗（CSBI）在膀胱癌（BC）复发方面是否存在差异。
回顾性分析 1994 年 3 月至 2020 年 8 月间行经尿道膀胱肿瘤切除术的 1482 例患者的病历资料。根据 IPOIC 和/或 CSBI 给药情况将患者分为两组[组 1=单独 CSBI；组 2=CSBI 后 IPOIC]。根据 IPOIC 和/或 CSBI 给药情况，将低危和中危 NMIBC 患者进一步分为亚组。
共纳入 594 例原发性 NMIBC 患者。其中，86 例（14.5%）为女性，508 例（85.5%）为男性，中位年龄为 69（60-78）岁。组 1 和组 2 中患者的例数分别为 361 例（60.8%）和 233 例（39.2%）。213 例（35.9%）患者出现疾病复发。两组间疾病复发频率、首次复发中位时间及 12 个月内复发频率无差异（P=0.064、P=0.671 和 P=0.145）。与单独 CSBI 相比，低危 NMIBC 患者采用“IPOIC 后 CSBI”治疗时，疾病复发率更低（P=0.042）。然而，两组间复发肿瘤的病理特征（数量、大小、分级、分期和原位癌存在情况）比较无差异（P＞0.05，各指标）。
IPOIC 联合 CSBI 并不优于单独 CSBI，不能预防低危和中危 NMIBC 患者的不良病理结局。
