Prophylactic oral methotrexate therapy for multiple superficial bladder carcinoma.

Sixteen patients with multiple, frequently recurring Ta/T1 transitional cell carcinoma of the bladder were treated with methotrexate syrup 50 mg orally every week, for 18 months. In 11 patients the frequency, number and size of tumour recurrences decreased markedly. In 3 patients the incidence of tumour recurrence appeared unchanged and in 2 patients the disease progressed and required cystectomy. Overall, the average number of tumours recurring per patient month at risk fell significantly from 2.6 to 1.2 while taking methotrexate. It is suggested that oral methotrexate may provide an effective alternative to intravesical chemotherapy for the prevention of recurrent superficial bladder carcinoma.