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Intravesical mitomycin C combined with local microwave hyperthermia in non-muscle-invasive bladder cancer with increased European Organization for Research and Treatment of Cancer (EORTC) score risk of recurrence and progression

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Abstract

Purpose

To assess the activity of intravesical chemotherapy and local microwave hyperthermia (ICLMH) in increasing the disease-free interval (DFI) in patients with non-muscle-invasive bladder cancer (NMIBC) and treatment toxicity.

Methods

Forty-two patients with a diagnosis of high-risk NMIBC, according to the European Organization for Research and Treatment of Cancer (EORTC) criteria, were treated with an intensive schedule of ICLMH using 40 mg mitomycin C. The treatment consisted of 4 weekly sessions, followed by 6 sessions delivered every 2 weeks, and by 4 monthly sessions, for a total of 14 sessions over 8 months. The DFIs before and after treatment were compared in each patient.

Results

The schedule was completed as planned by 32 patients (76.2 %). The percentage of disease-free patients the year before study was 14.9 % (95 % CI 5.5–28.8) versus 88.8 % (95 % CI 73.7–94.8) after ICLMH (p < 0.0001). Patient EORTC scores, multifocality, and tumour stage were all associated significantly and independently with a higher risk of recurrence after ICLMH treatment with HR of 41.1 (p = 0.01), 17.7 (p = 0.02), and 8.5 (p = 0.02), respectively. After a median follow-up of 38 months, 24 patients (57.1 %) did not show evidence of disease, whereas 13 patients (30.9 %) underwent disease recurrence and 5 patients (11.9 %) showed also stage progression. Toxicity consisted in grades 1 and 2 frequency, non-infectious cystitis, and haematuria.

Conclusions

ICLMH significantly increases the DFI of NMIBC patients with high EORTC score for recurrence and progression. Toxicity of the intensive treatment schedule was generally mild.

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Acknowledgments

The authors have no financial interest with the Synergo device, nor with the drug used in the study.

Ethical standard

The study protocol was approved by the internal Ethics Committee at our institution, in accordance with the ethical standards of the Declaration of Helsinki and later amendments. All patients signed a written informed consent.

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Authors and Affiliations

  1. Urology Unit, National Institute of Cancer, Milan, Italy

    Massimo Maffezzini

  2. Urology Unit, Galliera Hospital, Genoa, Italy

    Fabio Campodonico, Giorgio Canepa & Stefania Tamagno

  3. Surgical Department, Cikini Hospital, Jakarta, Indonesia

    Egi Edward Manuputty

  4. Scientific Office and Biostatistics, Galliera Hospital, Genoa, Italy

    Matteo Puntoni

  5. Urology Unit, Galliera Hospital, Via Volta 8, 16128, Genoa, Italy

    Fabio Campodonico

Authors
  1. Massimo Maffezzini
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  2. Fabio Campodonico
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  3. Giorgio Canepa
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  4. Egi Edward Manuputty
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  5. Stefania Tamagno
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  6. Matteo Puntoni
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Corresponding author

Correspondence to Fabio Campodonico.

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Maffezzini, M., Campodonico, F., Canepa, G. et al. Intravesical mitomycin C combined with local microwave hyperthermia in non-muscle-invasive bladder cancer with increased European Organization for Research and Treatment of Cancer (EORTC) score risk of recurrence and progression. Cancer Chemother Pharmacol 73, 925–930 (2014). https://doi.org/10.1007/s00280-014-2423-y

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  • DOI: https://doi.org/10.1007/s00280-014-2423-y

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