Prophylactic Effect of Intravesical Epirubicin and Bacillus Calmette- Guerin Therapy in Stage T1 Bladder Cancer / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We compared the prophylatic effects and complications of intravesical instillation of the epirubicin and Bacillus Calmette-Guerin (BCG) in patients with stage T1 bladder cancer. MATERIALS AND METHODS: A total 87 patients with stage T1 bladder cancer were treated with transurethral resection (TUR) between January 1992 and April 1998. Of them, 51 patients received BCG (Connaught strain, 81mg), 16 patients received 50mg epirubicin and 20 patients underwent TUR alone. The patients were followed for 18-78 months (mean 40 months). Recurrence rates, progression rates, mean months to tumor recurrence, recurrence free survival rate using Kaplan-Meier curve and complications were compared among three groups. RESULTS: The overall recurrence rate was 27.5% in BCG group, 37.5% in epirubicin group and 65% in control group. Mean months to tumor recurrence and recurrence free survival rate showed that both drugs were superior to TUR alone. The incidence of complications was 94% in BCG group and 12.5% in epirubicin group. CONCLUSIONS: BCG and epirubicin were superior to TUR alone in the prophylaxis of recurrence in stage T1 bladder cancer. Although the prophylactic efficacy of BCG was a little higher than that of the epirubicin, the toxicity rate of epirubicin was much lower than that of BCG. Therefore, epirubicin may be regarded as an alternative treatment of the BCG, especially for the patients who cannot tolerate the side effects of BCG.