Abstract
Objective: To evaluate the outcome of post-TUR-BT combined chemo and immune-intravesical therapy in papillary transitional cell carcinoma of the urinary bladder.
Patients and Methods: From Sept. 2001 to August. 2007 in Alnoor specialist hospital , Holly Makkah K.S.A and Urology Department, Benha Faculty of Medicine 158 patients of papillary transitional cell carcinoma Ta,T1,T2 were treated by TUR-BT plus combined intravesical chemotherapy and immunotherapy. TUR-BT was repeated and intravesical combined therapy if recurrence occurred on 3,6 months cystoscopic follow up, percentage of the disease-free patient, recurrence, progression and survival with intact bladder were compared and analyzed.
Results: Follow up of the patients up to 5 years was done. At median follow up of about 24 months; 82 patients( 53.6%) were disease free and recurrence was detected in 31 patients (20%) and progression was in 4 patients (2.6%). The results of the follow up at the end of the 5 years revealed that the disease-free percentage was 64 patients (41.5%), recurrence was detected in 41 patients (26.8%) and progression was (14.4%) in 22 patients were shifted to cystectomy. Overall 5 year survival with intact bladder was 85.6% (131 patients), we did not follow cystectomy patients
Conclusions: Post TUR-BT combined intravesical chemo and immunotherapy is an appropriate option for the management of papillary transitional cell carcinoma of the urinary bladder and could preserve the intact bladder for a long period and should be applied even in muscle invasive T2 tumor before shifting to cystectomy .