A single institution experience of the safety and efficacy of using Hyperthermic Intravesical Chemotherapy (HIVEC) with Mitomycin C treatment for patients with intermediate and high-risk non-muscle-invasive bladder cancer (NMIBC).
BAUS ePoster online library. Conroy S. 06/22/21; 319003; p10-14
Disclosure(s): The Urology Foundation Research Scholar Award 2020-21
Ms. Samantha Conroy
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Abstract
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Introduction: Hyperthermic Intravesical Chemotherapy (HIVEC) with Mitomycin C is a novel adjuvant treatment in non-muscle-invasive bladder cancer (NMIBC). Here, we discuss our preliminary experience using adjuvant HIVEC in patients with intermediate-risk (IR-NMIBC) and high-risk (HR-NMIBC) NMIBC.
Patients and Methods: Patient and outcome data were collected prospectively in a dedicated clinic (9/8/17-28/10/19). Risk-stratified HIVEC protocols were utilised. The HR-NMIBC protocol (6+3+3) consists of induction (6 instillations) then check cystoscopy; patients clear of disease have 2 further maintenance cycles (3 instillations each), with interval cystoscopy. The IR-NMIBC protocol (6+3) consists of induction and 1 maintenance cycle, with interval cystoscopy. Patients not willing or unable to undergo cystectomy for recurrence are offered re-induction. Retrospective case note review was completed to evaluate clinical outcomes (1/9/20-8/12/20).
Results: 100 patients received HIVEC therapy (9/8/17-28/10/19). Table 1 describes patient and tumour characteristics. Median follow-up was 20months. 70% had HR-NMIBC. 42 patients had received prior intravesical therapy (35 BCG, 12 ambient MMC, 4 epirubicin). 28/35(80%) who received prior BCG, were BCG failures. Table 2 shows protocol and treatment outcomes. 8(8%) patients required radical treatment: 5 radical cystectomy; 3 radiotherapy. 12-month recurrence-free survival (RFS), progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were 71%, 96%, 100%, and 96% for IR-NMIBC, and 73%, 84%, 100%, and 97% for HR-NMIBC.
Conclusions: Here we present a risk-stratified NMIBC HIVEC treatment protocol that is safe and well-tolerated. In our cohort, with a large proportion of HR-NMIBC patients (70%), 12-month RFS, PFS, DSS, and OS rates in our cohort are promising.
Patients and Methods: Patient and outcome data were collected prospectively in a dedicated clinic (9/8/17-28/10/19). Risk-stratified HIVEC protocols were utilised. The HR-NMIBC protocol (6+3+3) consists of induction (6 instillations) then check cystoscopy; patients clear of disease have 2 further maintenance cycles (3 instillations each), with interval cystoscopy. The IR-NMIBC protocol (6+3) consists of induction and 1 maintenance cycle, with interval cystoscopy. Patients not willing or unable to undergo cystectomy for recurrence are offered re-induction. Retrospective case note review was completed to evaluate clinical outcomes (1/9/20-8/12/20).
Results: 100 patients received HIVEC therapy (9/8/17-28/10/19). Table 1 describes patient and tumour characteristics. Median follow-up was 20months. 70% had HR-NMIBC. 42 patients had received prior intravesical therapy (35 BCG, 12 ambient MMC, 4 epirubicin). 28/35(80%) who received prior BCG, were BCG failures. Table 2 shows protocol and treatment outcomes. 8(8%) patients required radical treatment: 5 radical cystectomy; 3 radiotherapy. 12-month recurrence-free survival (RFS), progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were 71%, 96%, 100%, and 96% for IR-NMIBC, and 73%, 84%, 100%, and 97% for HR-NMIBC.
Conclusions: Here we present a risk-stratified NMIBC HIVEC treatment protocol that is safe and well-tolerated. In our cohort, with a large proportion of HR-NMIBC patients (70%), 12-month RFS, PFS, DSS, and OS rates in our cohort are promising.
Introduction: Hyperthermic Intravesical Chemotherapy (HIVEC) with Mitomycin C is a novel adjuvant treatment in non-muscle-invasive bladder cancer (NMIBC). Here, we discuss our preliminary experience using adjuvant HIVEC in patients with intermediate-risk (IR-NMIBC) and high-risk (HR-NMIBC) NMIBC.
Patients and Methods: Patient and outcome data were collected prospectively in a dedicated clinic (9/8/17-28/10/19). Risk-stratified HIVEC protocols were utilised. The HR-NMIBC protocol (6+3+3) consists of induction (6 instillations) then check cystoscopy; patients clear of disease have 2 further maintenance cycles (3 instillations each), with interval cystoscopy. The IR-NMIBC protocol (6+3) consists of induction and 1 maintenance cycle, with interval cystoscopy. Patients not willing or unable to undergo cystectomy for recurrence are offered re-induction. Retrospective case note review was completed to evaluate clinical outcomes (1/9/20-8/12/20).
Results: 100 patients received HIVEC therapy (9/8/17-28/10/19). Table 1 describes patient and tumour characteristics. Median follow-up was 20months. 70% had HR-NMIBC. 42 patients had received prior intravesical therapy (35 BCG, 12 ambient MMC, 4 epirubicin). 28/35(80%) who received prior BCG, were BCG failures. Table 2 shows protocol and treatment outcomes. 8(8%) patients required radical treatment: 5 radical cystectomy; 3 radiotherapy. 12-month recurrence-free survival (RFS), progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were 71%, 96%, 100%, and 96% for IR-NMIBC, and 73%, 84%, 100%, and 97% for HR-NMIBC.
Conclusions: Here we present a risk-stratified NMIBC HIVEC treatment protocol that is safe and well-tolerated. In our cohort, with a large proportion of HR-NMIBC patients (70%), 12-month RFS, PFS, DSS, and OS rates in our cohort are promising.
Patients and Methods: Patient and outcome data were collected prospectively in a dedicated clinic (9/8/17-28/10/19). Risk-stratified HIVEC protocols were utilised. The HR-NMIBC protocol (6+3+3) consists of induction (6 instillations) then check cystoscopy; patients clear of disease have 2 further maintenance cycles (3 instillations each), with interval cystoscopy. The IR-NMIBC protocol (6+3) consists of induction and 1 maintenance cycle, with interval cystoscopy. Patients not willing or unable to undergo cystectomy for recurrence are offered re-induction. Retrospective case note review was completed to evaluate clinical outcomes (1/9/20-8/12/20).
Results: 100 patients received HIVEC therapy (9/8/17-28/10/19). Table 1 describes patient and tumour characteristics. Median follow-up was 20months. 70% had HR-NMIBC. 42 patients had received prior intravesical therapy (35 BCG, 12 ambient MMC, 4 epirubicin). 28/35(80%) who received prior BCG, were BCG failures. Table 2 shows protocol and treatment outcomes. 8(8%) patients required radical treatment: 5 radical cystectomy; 3 radiotherapy. 12-month recurrence-free survival (RFS), progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) were 71%, 96%, 100%, and 96% for IR-NMIBC, and 73%, 84%, 100%, and 97% for HR-NMIBC.
Conclusions: Here we present a risk-stratified NMIBC HIVEC treatment protocol that is safe and well-tolerated. In our cohort, with a large proportion of HR-NMIBC patients (70%), 12-month RFS, PFS, DSS, and OS rates in our cohort are promising.
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