Rapid tumour recurrence following cessation of long-term treatment with intravesical thiotepa.

OBJECTIVE

To report tumour recurrence related to cessation of long-term therapy with thiotepa.

PATIENTS AND METHODS

A group of 12 patients with low grade (I-II), low stage (TA-T1) transitional cell carcinoma of the bladder were included in the study. All patients had been treated with intravesical thiotepa for a period ranging from 24 to 71 months and none had had a recurrence for a period of between 15 and 51 months. After referral to this department all the patients were withdrawn from thiotepa therapy.

RESULTS

All the patients developed bladder tumours within 6 months of cessation of therapy. The recurrent tumours were grade II in 10 patients and grade III in two patients. Eight patients had stage TA and four had stage T1. All responded to bacille Calmette-Guérin therapy and none had tumour recurrence on follow up at 24 months.

CONCLUSION

Meticulous follow-up of patients is indicated soon after the cessation of long-term therapy with thiotepa.