Outcome of post-TUR-BT combined chemo and immuno intravesical therapy in the management of papillary transitional cell carcinoma of the urinary bladder

ABSTRACT

To evaluate the outcome of post-TUR-BT combined chemo-and immune-intravesical therapy in papillary transitional cell carcinoma of the urinary bladder. From Sept 2001 to August 2007 in Alnoor specialist'hospital, Holly Makkah K.S,A and Urology Department, Benha Faculty of Medicine 158 patients of papillary transitional cell carcinoma Ta,T1,T2 were treated by TUR-BT plus combined intravesical chemotherapy and immunotherapy. TUR-BT was repeated and intravesical combined therapy if recurrence occurred on 3, 6 months cystoscopic follow up, percentage of the disease-free patient, recurrence, progression and survival with intact bladder were compared and analyzed. Follow up of the patients up to 5 years was done. At median follow up of about 24 months; 82 patients [53.6%] were disease free and recurrence was detected in 31 patients [20%] and progression was in 4 patients [2.6%]. The results of the follow up at the end of the 5 years revealed that the disease-free percentage was 64 patients [41.5%], recurrence was detected in 41 patients [26.8%] and progression was [14.4%] in 22 patients were shifted to cystectomy. Overall 5 year survival with intact bladder was 85.6% [131 patients], we did not follow cystectomy patients. Post TUR-BT combined intravesical chemo and immuno-therapy is an appropriate option for the management of papillary transitional cell carcinoma of the urinary bladder and could preserve the intact bladder for a long period and should be applied even in muscle invasive T2 tumor before shifting to cystectomy