Thermochemotherapy for non-muscle-invasive bladder cancer: is there a chance to avoid early cystectomy?

Urol Int. 2012;89(3):311-8. doi: 10.1159/000341912. Epub 2012 Sep 7.


Objectives: Non-muscle-invasive bladder cancer is characterized by a high recurrence rate after primary transurethral resection. In case of bacillus Calmette-Guérin-refractory neoplasms, cystectomy is the gold standard. In this study the effects of thermochemotherapy with mitomycin C were evaluated in high-risk bladder cancer nonresponders to previous therapy.

Patients and methods: Between January 2006 and December 2009, 30 patients were enrolled with recurrent stage carcinoma in situ, Ta and T1, grade G1 to G3 non-muscle-invasive bladder cancer refractory to chemotherapy or immunotherapy and so becoming suitable for radical cystectomy. All patients underwent endovesical thermochemotherapy: 16 patients underwent a prophylactic scheme and 14 patients underwent an ablative scheme.

Results: All the patients completed the study. The mean follow-up for all the patients enrolled was 14 months. Thirteen of 30 patients (43.30%) were disease free and 17 patients (56.70%) had recurrence. In the prophylactic group, 7 of 16 patients (43.75%) were disease free and 9 patients (46.25%) had tumor recurrence; no progression was observed. In the ablative group, 3 patients (17, 64%) had progression to muscle-invasive disease. Side effects were generally mild.

Conclusions: Thermochemotherapy could be considered an additional tool in patients refractory to intravesical therapies before considering early cystectomy.

MeSH terms

  • Cystectomy / methods
  • Cystoscopy / methods
  • Disease Progression
  • Disease-Free Survival
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / methods*
  • Male
  • Medical Oncology / methods
  • Recurrence
  • Risk
  • Treatment Outcome
  • Urinary Bladder Neoplasms / drug therapy*
  • Urology / methods*