Comparison of different schedules of cytostatic intravesical instillations in patients with superficial bladder carcinoma: final evaluation of a prospective multicenter study with 419 patients.

In a prospective multicenter study we compared the value of various protocols of mitomycin C and doxorubicin instillation for the prevention of recurrent tumors in patients whose superficial bladder tumors (stages TA and T1) had been removed by transurethral resection. The 3-year and short-term instillation protocols were compared to each other and to a combination of 2 protocols. Evaluation after a mean followup of 28 months confirmed the value of cytostatic bladder instillation in preventing recurrence and progression of tumor in patients with superficial bladder carcinoma. There was no significant difference between the results of long-term and short-term prophylaxis; their combination achieved the best results. Doxorubicin and mitomycin yielded similar results; mitomycin was better tolerated.

[The value of lymphography of malignant testicular tumors]. / Der Stellenwert der Lymphographie bei malignen Hodentumoren.

Between 1965 and 1968, 6500 lymphograms were performed at the University of Göttingen. Amongst these, there were 412 patients with malignant testicular tumours. In 81 patients the results of lymphography could be checked histologically. There was agreement between the lymphographic and histological findings in 65 patients (80.3%), sensitivity of 98.1% (51 out of 52) and specificity of 48.3% (14 out of 29). In 50 patients CT was performed in addition. The findings agreed in 31 cases; in eight patients lymphangiography resulted in a false positive finding and CT was incorrect in 12 patients. In all patients with proven retroperitoneal metastases, one or the other method produced a correct diagnosis.

Cytostatic intravesical instillation in patients with superficial bladder carcinoma for the prevention of recurrent tumors.

The value of various protocols of mitomycin C and adriamycin instillation for the prevention of recurrent tumors in patients whose superficial bladder tumors (TA, T1) had been removed by transurethral resection was compared in a prospective multicenter study. Three-year and short-term instillation protocols were compared with each other and with the combination of the two. Evaluation after a mean follow-up of 20 months confirmed our previous conclusion of the great value of cytostatic bladder instillation to prevent recurrent tumors and tumor progression in patients with superficial bladder carcinoma. There is no significant difference between long-term and short-term prophylaxis, but combination has achieved the best results. Similar results were obtained with adriamycin and mitomycin but adriamycin was less well tolerated.

[Differential therapy of advanced bladder carcinoma and of postoperative adjuvant chemotherapy (author's transl)]. / Differentialtherapie des fortgeschrittenen Blasenkarzinoms unter Berücksichtigung neuer chemotherapeutischer Aspekte.

Advanced bladder carcinoma still has a poor prognosis. While the five-year-survival in stage T1N0M0 is about 80%, less than 50% of the patients in stage T2N0M0 survive 5 years. This prognosis could not be altered by a more radical operation or by radiation therapy. Therefore we started postoperative adjuvant chemotherapy in 1972. First we tested the effect of three different cytostatic drug therapy schedules. Although successful treatment was achieved in several cases, there were other patients who did not respond to one of the three therapy schedules. We then started applying all three schedules, one after the other, in intervals of 4 weeks. Therapeutic procedure now is: After diagnosis by cystoscopy and histology and TNM-classification, urologic therapy is performed (electroresection, cystectomy, etc.). Then in stage T2-4N0-1M0-1 postoperative adjuvant chemotherapy follows. Thus far, we have achieved complete remission in all patients except one (after radiation therapy). No definite comments as to survival can be made at this time.