Cancer Chemotherapy and Pharmacology

, Volume 30, Supplement 1, pp S15–S20 | Cite as

Long-term results of intravesical chemoprophylaxis of superficial bladder cancer: experience of the Japanese urological cancer research group for Adriamycin

  • Hideyuki Akaza
  • Kenkichi Koiso
  • Toshihiko Kotake
  • Yosuke Matsumura
  • Shigeo Isaka
  • Toyohei Machida
  • Koji Obata
  • Yasuo Ohashi
  • Hiroshi Ohe
  • Yoshitada Ohi
  • Jun Shimazaki
  • Kazuya Tashiro
  • Toyofumi Ueda
  • Susumu Kagawa
  • Tadao Niijima
  • The Japanese Urological Cancer Research Group for Adriamycin
Intravesical Instillation I. Prophylactic Therapy Superficial Bladder Cancer, Adriamycin, Intravesical Chemotherapy

Summary

Long-term results were analyzed in terms of tumor progression and survival in patients with superficial bladder cancer who were enrolled in the second intravesical chemoprophylactic study of the Japanese Urological Cancer Research Group for Adriamycin, which was started in July 1982. This study was a prospective, randomized, controlled trial conducted on primary tumors treated with a long-term instillation regimen that involved control versus intravesical instillations of Adriamycin or mitomycin C given once a week for the first 2 weeks, once every other week for 14 weeks, once a month for 8 months, and once every 3 months for 1 year, for a total of 21 instillations in 2 years. An analysis of the prophylactic effects of such treatment on bladder tumors after TUR has previously been performed, and the results have been published elsewhere. The present study represents a follow-up of the above trial. Of the 671 cases previously analyzed with regard to tumor prophylaxis, 158 cases (23.5%) were eligible to be followed for tumor progression and survival. A detailed comparison of the background factors between these 158 patients and the other 513 cases revealed no statistically significant difference. Thus, the 158 evaluable cases might reasonably be considered to represent all patients enrolled in the second study, and the results were thought to be reasonable enough to reflect the long-term efficacy of the long-term instillation regimen adopted in this study. The median follow-up for these 158 cases was 6.6 years. Tumor progression in terms of the disease stage and/or grade occurred in 43 of 127 patients who received prophylactic instillations and in 12 of 31 control cases. No significant difference in the incidence of tumor progression was found between the treatment and the control groups. In addition, no difference in survival was observed between the treatment group and the control group. Survival was also compared between patients who showed tumor progression and those who did not. All patients whose tumors did not progress survived, whereas the 7-year survival of those exhibiting tumor progression was <90%.

Keywords

Tumor Progression Disease Stage Control Case Mitomycin Adriamycin 

References

  1. 1.
    Akaza H, Isaka S, Koiso K, Kotake K, Machida T, Maru A, Matsumura Y, Niijima T, Obata K, Ohe H, Ohi Y, Shimazaki J, Tashiro K, Ueda T, Uyama T, the Japanese Urological Cancer Research Group for Adriamycin (1987) Comparative analysis of short-term and longterm prophylactic intravesical chemotherapy of superficial bladder cancer. Prospective, randomized, controlled studies of the Japanese Urological Cancer Research Group. Cancer Chemother Pharmacol 20 [Suppl]: S91Google Scholar
  2. 2.
    Huland H, Klöppel G, Feddersen I, Otto U, Brachmann W, Hubmann H, Kaufmann J, Knipper W, Lantzius-Beninga F, Huland E (1990) Comparison of different schedules of cytostatic intravesical instillation in patients with superficial bladder cancer: final evaluation of a prospective multicenter study with 419 patients. J Urol 144: 68Google Scholar
  3. 3.
    Niijima T, Koiso K, Akaza H, the Japanese Urological Cancer Research for Adriamycin (1983) Randomized clinical trial on chemoprophylaxis of recurrence in cases of superficial bladder cancer. Cancer Chemother Pharmacol 11 [Suppl]: S79Google Scholar
  4. 4.
    Prout GR Jr, Marshall VF (1956) The prognosis with untreated bladder tumors. Cancer 9: 551Google Scholar
  5. 5.
    Schulman CC, Denis LJ, Oosterlinck W, De Sy W, Chantrie M, Bouffioux C, Van Changh PJ, Van Erps P (1983) Early adjuvant Adriamycin in superficial bladder carcinoma. World J Urol 1: 86Google Scholar
  6. 6.
    Torti FM, Lum BL (1984) The biology and treatment of superficial bladder cancer. J Clin Oncol 2: 505Google Scholar
  7. 7.
    UICC (1987) Bladder. In: Hermanek P, Sobin LH (eds) TNM classification of malignant tumours, 4th edn. UICC, Geneva, p 133Google Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Hideyuki Akaza
    • 13
  • Kenkichi Koiso
    • 13
  • Toshihiko Kotake
    • 1
  • Yosuke Matsumura
    • 2
  • Shigeo Isaka
    • 3
  • Toyohei Machida
    • 4
  • Koji Obata
    • 5
  • Yasuo Ohashi
    • 6
  • Hiroshi Ohe
    • 7
  • Yoshitada Ohi
    • 8
  • Jun Shimazaki
    • 3
  • Kazuya Tashiro
    • 9
  • Toyofumi Ueda
    • 10
  • Susumu Kagawa
    • 11
  • Tadao Niijima
    • 12
  • The Japanese Urological Cancer Research Group for Adriamycin
  1. 1.Department of UrologyThe Center for Adult DiseasesOsakaJapan
  2. 2.Department of UrologyKobe West City HospitalKobeJapan
  3. 3.Department of Urology, School of MedicineChiba UniversityChibaJapan
  4. 4.Department of UrologyJikei University School of MedicineTokioJapan
  5. 5.Department of UrologyJapanese Red Cross Nagoya Second HospitalNagoyaJapan
  6. 6.Department of Epidemiology and Biostatistics, School of Health SciencesUniversity of TokyoTokyoJapan
  7. 7.Department of UrologyKyoto Prefectural University of MedicineKyotoJapan
  8. 8.Department of Urology, School of MedicineKagoshima UniversityKagoshimaJapan
  9. 9.Department of UrologyAtsugi Prefectural HospitalAtsugiJapan
  10. 10.Department of Urology, Faculty of MedicineKyushu UniversityKyushuJapan
  11. 11.Department of Urology, School of MedicineUniversity of TokushimaTokushimaJapan
  12. 12.Tokyo Seamen's Insurance HospitalTokyoJapan
  13. 13.Department of Urology, Institute of MedicineUniversity of TsukubaTsukuba-City, IbarakiJapan

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