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Original Article | Open Access

A multi-institutional retrospective study of hyperthermic plus intravesical chemotherapy versus intravesical chemotherapy treatment alone in intermediate and high risk nonmuscle-invasive bladder cancer

Qiang Ruan1,2,*, Degang Ding3,*, Bin Wang4, Chaohong He5, Xuequn Ren6( ), Zhenhua Feng7, Zhigang Pang8, Jin Wang1, Xiangliang Zhang1, Hongsheng Tang1, Jiahong Wang1, Qingjun He1, Ziying Lei1, Quanxing Liao1, Jiali Luo1, Shuzhong Cui1 ( )
Department of Abdominal Surgery, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou 510095, China
The First Affiliated Hospital of Jinan University, the First Clinical Medical College of Jinan University, Guangzhou 510630, China
Department of Urinary Surgery, Henan Provincial People’s Hospital, Zhengzhou 450003, China
Department of Urinary Surgery, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou 510095, China
Department of Urinary Surgery, Henan Cancer Hospital, Zhengzhou 450008, China
Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, China
Department of Urinary Surgery, Gaozhou People’s Hospital, Maoming 525200, China
Department of General Surgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, China

*These authors contributed equally to this work.

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Abstract

Objective

To compare the efficacy and safety of hyperthermic intravesical chemotherapy (HIVEC) and intravesical chemotherapy (IVEC) in patients with intermediate and high risk nonmuscle-invasive bladder cancer (NMIBC) after transurethral resection.

Methods

We included 560 patients diagnosed with primary or recurrent NMIBC between April 2009 and December 2015 at 1 of 6 tertiary centers. We matched 364 intermediate or high risk cases and divided them into 2 groups: the HIVEC+IVEC group [chemohyperthermia (CHT) composed of 3 consecutive sessions followed by intravesical instillation without hyperthermia] and the IVEC group (intravesical instillation without hyperthermia). The data were recorded in the database. The primary endpoint was 2-year recurrence-free survival (RFS) in all NMIBC patients (n = 364), whereas the secondary endpoints were the assessment of radical cystectomy (RC) and 5-year overall survival (OS).

Results

There was a significant difference in the 2-year RFS between the two groups in all patients (n = 364; HIVEC+IVEC: 82.42% vs. IVEC: 74.18%, P = 0.038). Compared with the IVEC group, the HIVEC+IVEC group had a lower incidence of RC (P = 0.0274). However, the 5-year OS was the same between the 2 groups (P = 0.1434). Adverse events (AEs) occurred in 32.7% of all patients, but none of the events was serious (grades 3–4). No difference in the incidence or severity of AEs between each treatment modality was observed.

Conclusions

This retrospective study showed that HIVEC+IVEC had a higher 2-year RFS and a lower incidence of RC than IVEC therapy in intermediate and high risk NMIBC patients. Both treatments were well-tolerated in a similar manner.

Keywords

hyperthermiaNonmuscle-invasive bladder cancerintravesical chemotherapychemohyperthermiaretrospective study

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Cancer Biology & Medicine
Volume 18 Issue 1,
February 2021
Pages 308-317
DOI: 10.20892/j.issn.2095-3941.2020.0125
Cite this article:
Ruan Q, Ding D, Wang B, et al. A multi-institutional retrospective study of hyperthermic plus intravesical chemotherapy versus intravesical chemotherapy treatment alone in intermediate and high risk nonmuscle-invasive bladder cancer. Cancer Biology & Medicine, 2021, 18(1): 308-317. https://doi.org/10.20892/j.issn.2095-3941.2020.0125

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Received: 23 March 2020
Accepted: 10 July 2020
Published: 01 February 2021
©2021 Cancer Biology & Medicine.

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