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Multicenter Study
. 2023 Nov;41(11):3195-3203.
doi: 10.1007/s00345-023-04332-z. Epub 2023 Feb 22.

Efficacy of hyperthermic intravesical chemotherapy (HIVEC) in patients with non-muscle invasive bladder cancer after BCG failure

Géraldine Pignot  1 , Michael Baboudjian  2 , Cédric Lebacle  3 , Alexandre Chamouni  4 , Eric Lechevallier  2 , Jacques Irani  3 , Xavier Tillou  5 , Thibaut Waeckel  5 , Arnaud Monges  6 , Laure Doisy  7 , Jochen Walz  7 , Gwenaelle Gravis  8 , Eric Mourey  9 , Céline Duperron  9 , Alexandra Masson-Lecomte  4
Affiliations
Multicenter Study

Efficacy of hyperthermic intravesical chemotherapy (HIVEC) in patients with non-muscle invasive bladder cancer after BCG failure

Géraldine Pignot et al. World J Urol. 2023 Nov.

Abstract

Purpose: To evaluate hyperthermic intravesical chemotherapy (HIVEC) efficacy regarding 1-year disease-free survival (RFS) rate and bladder preservation rate in patients with non-muscle invasive bladder cancer (NMIBC) who fail bacillus Calmette-Guérin (BCG) therapy.

Methods: This is a multicenter retrospective series from a national database (7 expert centers). Between January 2016 and October 2021, patients treated with HIVEC for NMIBC who failed BCG have been included in our study. These patients had a theoretical indication for cystectomy but were ineligible for surgery or refused it.

Results: A total of 116 patients treated with HIVEC and with a follow-up > 6 months were included in this study and retrospectively analyzed. The median follow-up was 20.6 months. The 12 month-RFS (recurrence-free survival) rate was 62.9%. The bladder preservation rate was 87.1%. Fifteen patients (12.9%) progressed to muscle infiltration, three of them having a metastatic disease at the time of progression. Predictive factors of progression were T1 stage, high grade and very high-risk tumors according to the EORTC classification.

Conclusion: Chemohyperthermia using HIVEC achieved an RFS rate of 62.9% at 1 year and enabled a bladder preservation rate of 87.1%. However, the risk of progression to muscle-invasive disease is not negligible, particularly for patients with very high-risk tumors. In these patients who fail BCG, cystectomy should remain the standard of care and HIVEC may be discussed cautiously for patients who are not eligible for surgery and well informed of the risk of progression.

Keywords: BCG-unresponsive; Bladder cancer; Chemohyperthermia; Cystectomy; Progression; Recurrence.

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References

    1. Witjes JA (2006) Management of BCG failures in superficial bladder cancer: a review. Eur Urol 49(5):790–797. https://doi.org/10.1016/j.eururo.2006.01.017 - DOI - PubMed
    1. Babjuk M, Burger M, Capoun O, Cohen D, Compérat EM, Dominguez Escrig JL et al (2022) European association of urology guidelines on non-muscle-invasive bladder cancer (TaT1 and Carcinoma In Situ). Eur Urol 81(1):75–94. https://doi.org/10.1016/j.eururo.2021.08.010 - DOI - PubMed
    1. van der Heijden AG, Verhaegh G, Jansen CFJ, Schalken JA, Witjes JA (2015) Effect of hyperthermia on the cytotoxicity of 4 chemotherapeutic agents currently used for the treatment of transitional cell carcinoma of the bladder: an in vitro study. J Urol 173(4):1375–1380. https://doi.org/10.1097/01.ju.0000146274.85012.e1 - DOI
    1. Arends TJH, Nativ O, Maffezzini M, de Cobelli O, Canepa G, Verweij F et al (2016) Results of a randomised controlled trial comparing intravesical chemohyperthermia with mitomycin C versus bacillus Calmette-Guérin for adjuvant treatment of patients with intermediate- and high-risk non–muscle-invasive bladder cancer. Eur Urol 69(6):1046–1052. https://doi.org/10.1016/j.eururo.2016.01.006 - DOI - PubMed
    1. Tan WS, Panchal A, Buckley L, Devall AJ, Loubière LS, Pope AM et al (2019) Radiofrequency-induced thermo-chemotherapy effect versus a second course of Bacillus Calmette-Guérin or institutional standard in patients with recurrence of non-muscle-invasive bladder cancer following induction or maintenance Bacillus Calmette-Guérin therapy (HYMN): a phase III, open-label. Randomised Controlled Trial Eur Urol 75(1):63–71. https://doi.org/10.1016/j.eururo.2018.09.005 - DOI - PubMed

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