PMID- 37025474
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2688-4526 (Electronic)
IS  - 2688-4526 (Linking)
VI  - 4
IP  - 3
DP  - 2023 May
TI  - Hyperthermic intravesical chemotherapy with mitomycin-C for the treatment of 
      high-risk non-muscle-invasive bladder cancer patients.
PG  - 314-321
LID - 10.1002/bco2.203 [doi]
AB  - OBJECTIVES: The objectives of the study are to explore tolerability, 
      acceptability and oncological outcomes for patients with high-risk 
      non-muscle-invasive bladder cancer (NMIBC) treated with hyperthermic intravesical 
      chemotherapy (HIVEC) and mitomycin-C (MMC) at our institution. PATIENTS AND 
      METHODS: Our single-institution, observational study consists of consecutive 
      high-risk NMIBC patients treated with HIVEC and MMC. Our HIVEC protocol included 
      six weekly instillations (induction), followed by two further cycles of three 
      instillations (maintenance) (6 + 3 + 3) if there was cystoscopic response. 
      Patient demographics, instillation dates and adverse events (AEs) were collected 
      prospectively in our dedicated HIVEC clinic. Retrospective case-note review was 
      performed to evaluate oncological outcomes. Primary outcomes were tolerability 
      and acceptability of HIVEC protocol; secondary outcomes were 12-month 
      recurrence-free, progression-free and overall survival. RESULTS: In total, 57 
      patients (median age 80.3 years) received HIVEC and MMC, with a median follow-up 
      of 18 months. Of these, 40 (70.2%) had recurrent tumours, and 29 (50.9%) had 
      received prior Bacillus Calmette-Guerin (BCG). HIVEC induction was completed by 
      47 (82.5%) patients, but only 19 (33.3%) completed the full protocol. Disease 
      recurrence (28.9%) and AEs (28.9%) were the most common reasons for incompletion 
      of protocol; five (13.2%) patients stopped treatment due to logistical 
      challenges. AEs occurred in 20 (35.1%) patients; the most frequently documented 
      were rash (10.5%), urinary tract infection (8.8%) and bladder spasm (8.8%). 
      Progression during treatment occurred in 11 (19.3%) patients, 4 (7.0%) of whom 
      had muscle invasion and 5 (8.8%) subsequently required radical treatment. 
      Patients who had received prior BCG were significantly more likely to progress 
      (p = 0.04). 12-month recurrence-free, progression-free and overall survival rates 
      were 67.5%, 82.2%, and 94.7%, respectively. CONCLUSIONS: Our single-institution 
      experience suggests that HIVEC and MMC are tolerable and acceptable. Oncological 
      outcomes in this predominantly elderly, pretreated cohort are promising; however, 
      disease progression was higher in patients pretreated with BCG. Further 
      randomised noninferiority trials comparing HIVEC versus BCG in high-risk NMIBC 
      are required.
CI  - (c) 2022 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of 
      BJU International Company.
FAU - Conroy, Samantha
AU  - Conroy S
AUID- ORCID: 0000-0001-7167-4908
AD  - Academic Urology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
FAU - Pang, Karl
AU  - Pang K
AD  - Academic Urology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
FAU - Jubber, Ibrahim
AU  - Jubber I
AUID- ORCID: 0000-0002-4558-2521
AD  - Academic Urology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
FAU - Hussain, Syed A
AU  - Hussain SA
AD  - Academic Oncology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
FAU - Rosario, Derek J
AU  - Rosario DJ
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
FAU - Cumberbatch, Marcus G
AU  - Cumberbatch MG
AD  - Academic Urology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
FAU - Catto, James W F
AU  - Catto JWF
AD  - Academic Urology Unit, Department of Oncology and Metabolism University of 
      Sheffield Sheffield UK.
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
FAU - Noon, Aidan P
AU  - Noon AP
AD  - Department of Urology Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 
      UK.
LA  - eng
PT  - Journal Article
DEP - 20221202
PL  - United States
TA  - BJUI Compass
JT  - BJUI compass
JID - 101764975
PMC - PMC10071075
OTO - NOTNLM
OT  - acceptability
OT  - high risk
OT  - hyperthermic intravesical chemotherapy
OT  - intravesical treatment
OT  - mitomycin C
OT  - non-muscle-invasive bladder cancer
OT  - tolerability
COIS- There are no conflicts of interest to disclose.
EDAT- 2023/04/08 06:00
MHDA- 2023/04/08 06:01
PMCR- 2022/12/02
CRDT- 2023/04/07 02:30
PHST- 2022/09/01 00:00 [received]
PHST- 2022/10/28 00:00 [accepted]
PHST- 2023/04/08 06:01 [medline]
PHST- 2023/04/07 02:30 [entrez]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2022/12/02 00:00 [pmc-release]
AID - BCO2203 [pii]
AID - 10.1002/bco2.203 [doi]
PST - epublish
SO  - BJUI Compass. 2022 Dec 2;4(3):314-321. doi: 10.1002/bco2.203. eCollection 2023 
      May.