0000000000362157
AUTHOR
Andrea Salonia
LOCAL MICROWAVE HYPERTHERMIA AND INTRAVESICAL CHEMOTHERAPY AS BLADDER SPARING TREATMENT FOR SELECT MULTIFOCAL AND UNRESECTABLE SUPERFICIAL BLADDER TUMORS
Purpose: The role of a combined regimen of local hyperthermia and topical chemotherapy in patients with multifocal and recurrent superficial bladder tumors not curable by transurethral resection was evaluated in a neodjuvant organ sparing clinical study. Materials and Methods: A total of 19 patients with multifocal, superficial grades 1 to 3 bladder tumors that recurred after intravesical chemoprophylaxis or immunoprophylaxis underwent local combined administration of microwave induced hyperthermia and intravesical chemotherapy as a debulking approach. Due to extensive superficial involvement of the bladder walls complete transurethral resection of all tumors seemed technically unfeasible i…
Combination of intravesical chemotherapy and hyperthermia for the treatment of superficial bladder cancer: preliminary clinical experience
The prevalence of superficial transitional cell carcinoma of the bladder (STCCB) is still increasing in spite of improved adjuvant chemotherapic and/or immunoprophylaxis approaches. Thus, there is certainly an urgent need to improve our ability to control this disease. Local hyperthermia has a therapeutical potential for the treatment of many solid tumors, especially when used in combination with other treatments, such as radiation and chemotherapy. In particular, a synergistic or, at least, supra-additive antitumor cell killing effect was documented when local hyperthermia was administered in combination with selected cytostatic drugs. Recently, advances in miniaturized technology have all…
Effect on postoperative survival of the status of distal ureteral margin: The necessity to achieve negative margins at the time of radical cystectomy.
Background: Despite several studies, the adequate management of positive distal ureter margins at the time of radical cystectomy (RC) remains controversial. Particularly, it is not clear whether the achievement of negative distal ureter margins at the intraoperative frozen sections (IFS) affects postoperative cancer-specific mortality (CSM). Methods: In all, 1,447 consecutive patients treated with RC at a single center between January 1987 and August 2014 were considered. Multivariable (MVA) logistic regression analyses were used to determine predictors of positive IFS. MVA Cox regression analyses were used to test the effect on CSM of intraoperative conversion to negative margins. Results:…
Potential Effect of Antiplatelet and Anticoagulant Therapy on the Timing of the Diagnosis of Bladder Cancer
Abstract Background The most common presenting symptom of bladder cancer (BCa) is hematuria. The present study was designed to define whether patients taking antiplatelet and/or anticoagulant drugs might experience hematuria at an earlier stage or grade of BCa. Patients and Methods The data from 1532 consecutive patients who presented to the emergency unit of our institute from 2004 to 2012 because of gross hematuria as a single symptom were evaluated. Patients (n = 227) with a further diagnosis of BCa were included in our study. For the purpose of the present study, patients were divided into 2 groups: patients receiving antiplatelet or anticoagulant therapy (AAT) (group 1) and patients no…
The Impact of Perioperative Blood Transfusion on Survival of Bladder Cancer Patients Submitted to Radical Cystectomy: Role of Anemia Status.
Background The prognostic role of perioperative blood transfusion (PBT) in patients who underwent radical cystectomy (RC) for bladder cancer (BCa), although supported by clinical evidence, still remains to be assessed definitively. Objective To investigate the impact of PBT on RC patients for overall survival and after stratifying according to preoperative anemia status and to define whether the oncologic impact may be assumed to be a primary effect of PBT or attributed to the reduced preoperative hemoglobin (Hb) level. Design, setting, and participants A total of 1490 consecutive patients with nonmetastatic BCa who underwent RC and pelvic lymph node dissection between January 1990 and Augu…
Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC)
Study Type – Therapy (RCT) Level of Evidence 1b What’s known on the subject? and What does the study add? Microwave-induced hyperthermia and mitomycin C is a device-assisted approach used to treat non-muscle invasive bladder cancer (NMIBC) either in the adjuvant (prophylactic) set-up or in an ablative regimen. Until recently, around 20 different studies have been published with data on the short term results of treatment. Previous prospective randomized studies showed the superiority of the chemo-hyperthermia regimen when compared to intravesical chemotherapy alone in terms of recurrence-free survival in intermediate and high-risk NMIBC patients at minimum 24-month follow-up. The current st…