A multi-institutional retrospective study of hyperthermic plus intravesical chemotherapy versus intravesical chemotherapy treatment alone in intermediate and high risk nonmuscle-invasive bladder cancer
Qiang Ruan, Degang Ding, Bin Wang, Chaohong He, Xuequn Ren, Zhenhua Feng, Zhigang Pang, Jin Wang, Xiangliang Zhang, Hongsheng Tang, Jiahong Wang, Qingjun He, Ziying Lei, Quanxing Liao, Jiali Luo, Shuzhong Cui
Abstract
Objective: To compare the efficacy and safety of hyperthermic intravesical chemotherapy (HIVEC) and intravesical chemotherapy(IVEC) in patients with intermediate and high risk nonmuscle-invasive bladder cancer (NMIBC) after transurethral resection. Methods: We included 560 patients diagnosed with primary or recurrent NMIBC between April 2009 and December 2015 at 1of 6 tertiary centers. We matched 364 intermediate or high risk cases and divided them into 2 groups: the HIVEC+IVEC group[chemohyperthermia (CHT) composed of 3 consecutive sessions followed by intravesical instillation without hyperthermia] andthe IVEC group (intravesical instillation without hyperthermia). The data were recorded in the database. The primary endpointwas 2-year recurrence-free survival (RFS) in all NMIBC patients (n = 364), whereas the secondary endpoints were the assessment ofradical cystectomy (RC) and 5-year overall survival (OS). Results: There was a significant difference in the 2-year RFS between the two groups in all patients (n = 364; HIVEC+IVEC: 82.42% vs.IVEC: 74.18%, P = 0.038). Compared with the IVEC group, the HIVEC+IVEC group had a lower incidence of RC (P = 0.0274). However,the 5-year OS was the same between the 2 groups (P = 0.1434). Adverse events (AEs) occurred in 32.7% of all patients, but none of theevents was serious (grades 3–4). No difference in the incidence or severity of AEs between each treatment modality was observed. Conclusions: This retrospective study showed that HIVEC+IVEC had a higher 2-year RFS and a lower incidence of RC than IVECtherapy in intermediate and high risk NMIBC patients. Both treatments were well-tolerated in a similar manner.