Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 2, pp 487–494 | Cite as

Evaluation of the effects of intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone after transurethral resection of bladder tumor in T1-staged Grade 3 bladder cancer

  • Bin Huang
  • Hua Wang
  • Hao LinEmail author
  • Zhijun Yao
  • Jiabo Zheng
  • Wenzhe Fan
  • Shaopeng Qiu
  • Lingwu ChenEmail author
  • Junxing ChenEmail author
Original Article – Clinical Oncology



Comparing intra-arterial chemotherapy combined with intravesical chemotherapy against intravesical chemotherapy alone in the treatment of T1-staged Grade 3 (T1G3) bladder cancer after transurethral resection of bladder tumor (TURBT).

Materials and methods

From January 2007 to December 2012, 203 patients diagnosed with NMIBC were randomly assigned into either intra-arterial chemotherapy combined with intravesical chemotherapy group (Group A, n = 68) or intravesical chemotherapy alone group (Group B, n = 135) after TURBT. Four cycles of intra-arterial chemotherapy were administered after initial TURBT with 1-month interval between each. Intravesical chemotherapy was administered in both groups including an immediate 50 mg epirubicin instillation after TURBT and weekly maintenance for 8 weeks, and then followed by monthly maintenance for 1 year. The primary endpoint was recurrence-free survival.


Out of 203 patients, 53 were in Group A and 98 in Group B, and they were evaluated for recurrence and progression rate where recurrence rate was 35.8% (19/53) in group A and 41.8% (41/98) in group B with a significant difference (P < 0.05) and progression rate was 20.7% (11/53) in group A and 23.5% (23/98) in group B with a significant difference (P < 0.05). Univariate and multivariate logistic regression analysis suggested that intra-arterial chemotherapy could be an independent risk factors related to both overall survival and time to first recurrence.


Intra-arterial chemotherapy combined with intravesical chemotherapy could reduce the risk of recurrence and progression compared to intravesical chemotherapy alone in T1G3 bladder cancer.


Bladder cancer T1G3 Intra-arterial chemotherapy Intravesical chemotherapy Transurethral resection of bladder tumor 



This work was supported by grants from the National Natural Science Foundation of China (No.81402116) and Science and Technology Planning Project of Guangdong Province, China (Nos.2014A020212116, 2018A030307047) and Natural Science Foundation of Guangdong Province, China (No. 2017A030313847), Medical Scientific Research Foundation of Guangdong Province (A2018053), Shantou Science and Technology Project-Medical Treatment and Public Health Category (180709154010294).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. Chang SS et al (2016) Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO guideline. J Urol 196(4):1021–1029CrossRefGoogle Scholar
  2. Eapen L et al (2004) Effective bladder sparing therapy with intra-arterial cisplatin and radiotherapy for localized bladder cancer. J Urol 172(4 Pt 1):1276–1280CrossRefGoogle Scholar
  3. Hoshi S et al (1997) Internal iliac arterial infusion chemotherapy for rabbit invasive bladder cancer. Int J Urol 4(5):493–499CrossRefGoogle Scholar
  4. Kubota Y, Kakizaki H, Numasawa K (1986) Pre-operative one-shot intra-arterial infusion chemotherapy of bladder cancer. 2. The evaluation of the clinical usefulness of adriamycin and cisplatin. Nihon Hinyokika Gakkai Zasshi 77(6):909–913Google Scholar
  5. Kunimoto S et al (1983) Rapid uptake by cultured tumor cells and intracellular behavior of 4′-O-tetrahydropyranyl adriamycin. J Antibiot (Tokyo) 36(3):312–317CrossRefGoogle Scholar
  6. Li G et al (2017) Effect of cisplatin-based neoadjuvant chemotherapy on survival in patients with bladder cancer: a meta-analysis. Clin Invest Med 40(2):E81–E94CrossRefGoogle Scholar
  7. Liang S et al (2015) Intra-arterial chemotherapy for muscle-invasive bladder cancer following transurethral resection. Urol Int 94(4):406–411CrossRefGoogle Scholar
  8. Liu Z et al (2018) The effects of intra-arterial chemotherapy on bladder preservation in patients with T1 stage bladder cancer. World J Urol 36(8):1191–1200CrossRefGoogle Scholar
  9. Martin-Doyle W et al (2015) Improving selection criteria for early cystectomy in high-grade t1 bladder cancer: a meta-analysis of 15,215 patients. J Clin Oncol 33(6):643–650CrossRefGoogle Scholar
  10. Roupret M et al (2018) European association of urology guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur Urol 73(1):111–122CrossRefGoogle Scholar
  11. Skarlos DV et al (1997) Chemotherapy with methotrexate, vinblastine, epirubicin and carboplatin (Carbo-MVE) in transitional cell urothelial cancer. A Hellenic Co-Operative Oncology Group study. Eur Urol 31(4):420–427CrossRefGoogle Scholar
  12. Spiess PE, Cancer B et al (2017) Version 5.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 15(10):1240–1267CrossRefGoogle Scholar
  13. Sun F et al (2017) A prospective comparison of intra-arterial chemotherapy combined with intravesical chemotherapy and intravesical chemotherapy alone after transurethral resection with a thulium laser in high-risk non-muscle invasive bladder cancer. Cancer Chemother Pharmacol 79(6):1099–1107CrossRefGoogle Scholar
  14. Sylvester RJ, van der MA, Lamm DL (2002) Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 168(5):1964–1970CrossRefGoogle Scholar
  15. Sylvester RJ et al (2005) High-grade Ta urothelial carcinoma and carcinoma in situ of the bladder. Urology 66(6 Suppl 1):90–107CrossRefGoogle Scholar
  16. Sylvester RJ et al (2010) Long-term efficacy results of EORTC genito-urinary group randomized phase 3 study 30911 comparing intravesical instillations of epirubicin, bacillus Calmette-Guerin, and bacillus Calmette-Guerin plus isoniazid in patients with intermediate- and high-risk stage Ta T1 urothelial carcinoma of the bladder. Eur Urol 57(5):766–773CrossRefGoogle Scholar
  17. Woldu SL, Bagrodia A, Lotan Y (2017) Guideline of guidelines: non-muscle-invasive bladder cancer. BJU Int 119(3):371–380CrossRefGoogle Scholar
  18. Zhang Y et al (2016) Intravenous chemotherapy combined with intravesical chemotherapy to treat T1G3 bladder urothelial carcinoma after transurethral resection of bladder tumor: results of a retrospective study. Onco Targets Ther 5(Suppl 1):605–611Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of Urology, The Third Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  3. 3.Department of UrologyThe Second Affiliated Hospital of Shantou University Medical CollegeShantouChina
  4. 4.Department of UrologyThe Central Hospital of HengyangHengyangChina
  5. 5.Department of Gastrointestinal Surgery, The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  6. 6.Department of Interventional Oncology, The First Affiliated HospitalSun Yat-Sen UniversityGuangzhouChina
  7. 7.Department of UrologyHui Ya hospital of The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhouChina

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