表在性膀胱癌に対する経尿道的切除術直後Epirubicin膀胱内灌流療法の再発予防効果 A prospective controlled study

Abstract

著者等の方法は単発腫瘍に対して特に有用である可能性が示唆された.表在性膀胱癌の再発予防療法は腫瘍数によって層別化する必要がある

Between November 1994 and July 1996, 45 patients with superficial bladder tumor were assigned to two groups before transurethral resection of bladder tumor. Twenty-one of the 45 patients were instilled with 20 mg epirubicin before endoscopic resection then continuously irrigated with 40 micrograms/ml epirubicin solution for 20 hours immediately after surgery; 24 of the 45 patients received continuous irrigation with saline in the same manner. The patients were assessed by cystoscopy and urinary cytology every 3 months during the first 2 years and every 6 months thereafter. One year recurrence-free rates in the treated and control groups were 56% and 32%, respectively. The recurrence-free period tended to be longer in the treated group than in the control group, although the difference was not significant (p = 0.17). One year recurrence-free rates in the treated and control groups for the patients with solitary tumor were 88% and 48%, respectively, the difference being marginally significant (p = 0.06). These results suggested that continuous bladder irrigation with epirubicin was effective for patients with a single tumor. Therefore, the long-term prophylactic therapy for a single tumor was an overtreatment. Prophylactic intravesical chemotherapy for superficial bladder cancer was proposed to be stratified by the number of tumors, single or multiple.