Intensive intravesical chemotherapy in the treatment of flat carcinoma in situ: Is it safe?

M. J. Droller, Patrick Walsh

Research output: Contribution to journalArticle

Abstract

Recent enthusiasm for the use of intensive regimens of intravesical chemotherapy in the management of various forms of superficial transitional cell carcinoma of the bladder prompted us to examine retrospectively a group of patients with carcinoma in situ treated by such regimens who failed with progressive and metastatic cancer. Of 8 patients with flat carcinoma in situ treated with thiotepa 5 presented initially with concomitant solitary stage T1 papillary tumors that were resected successfully at initial presentation. Six patients had diffuse or multifocal carcinoma in situ, while 2 others had only a solitary focus of in situ disease. All patients had persistently positive urinary cytology studies during treatment, prompting 3 of them to receive intravesical mitomycin C following their course of thiotepa. Involvement of the prostatic urethra developed during therapy in 3 patients and 3 had muscle-infiltrative disease. At cystectomy 3 of 7 patients had positive pelvic lymph nodes and 4 died of distant metastases at an average of 8 months after cystectomy. These results suggest that despite the apparent advances that have been made in the control of recurrent superficial transitional cell bladder cancer, the intrinsic behavior of some forms of the disease may determine cancer progression. Identification of such patients is indicated for the institution of early aggressive treatment, which in the end may actually be the more conservative therapeutic approach.

Original languageEnglish (US)
Pages (from-to)1115-1117
Number of pages3
JournalJournal of Urology
Volume134
Issue number6
StatePublished - 1985

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Carcinoma in Situ
Drug Therapy
Thiotepa
Cystectomy
Therapeutics
Neoplasms
Transitional Cell Carcinoma
Mitomycin
Urethra
Urinary Bladder Neoplasms
Cell Biology
Urinary Bladder
Lymph Nodes
Neoplasm Metastasis
Muscles

ASJC Scopus subject areas

  • Urology

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Intensive intravesical chemotherapy in the treatment of flat carcinoma in situ : Is it safe? / Droller, M. J.; Walsh, Patrick.

In: Journal of Urology, Vol. 134, No. 6, 1985, p. 1115-1117.

Research output: Contribution to journalArticle

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