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[Post-Operative Single Immediate Intravesical Instillation Chemotherapy as Prophylaxis for Reccurence after

Shimpei Sugiura1, Noriaki Noto1, Mitsuyuki Koizumi1

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Hinyokika Kiyo. Acta Urologica Japonica
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A single dose of pirarubicine hydrochloride (THP) effectively reduced non-muscle-invasive bladder cancer recurrence. This chemoprophylaxis showed significant benefits compared to no treatment, improving non-recurrence rates post-surgery.

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Area of Science:

  • Urology
  • Oncology
  • Pharmacology

Background:

  • Non-muscle-invasive bladder cancer (NMIBC) poses a significant risk of recurrence after transurethral resection of bladder tumors (TURBT).
  • Adjuvant chemoprophylaxis is crucial for reducing recurrence rates and improving patient outcomes.
  • Pirarubicine hydrochloride (THP) is an anthracycline antibiotic with potential chemotherapeutic properties.

Purpose of the Study:

  • To evaluate the efficacy of single-dose pirarubicine hydrochloride (THP) instillation as chemoprophylaxis for NMIBC.
  • To compare the recurrence rates of NMIBC in patients receiving different THP regimens after TURBT.

Main Methods:

  • Retrospective study involving 135 evaluable patients with NMIBC post-TURBT.
  • Three groups were analyzed: no adjuvant therapy, single-dose THP immediately post-TURBT, and a multi-dose THP regimen initiated two weeks post-TURBT.
  • Patients were followed with cystoscopy and urine cytology for recurrence surveillance.

Main Results:

  • The 3- and 5-year non-recurrence rates were 66.9% and 66.0% (no therapy), 85.6% and 85.6% (single-dose THP), and 93.6% and 77.9% (multi-dose THP).
  • A significant difference in non-recurrence rates was observed between the no-therapy group and the single-dose THP group (P=0.048).
  • Recurrence rates per month showed a significant difference between the three groups during the first two years post-TURBT.

Conclusions:

  • Single-dose intravesical pirarubicine hydrochloride (THP) instillation is an effective chemoprophylactic strategy for NMIBC, significantly reducing recurrence rates.
  • While multi-dose THP showed higher initial non-recurrence rates, the long-term benefit of single-dose THP warrants consideration due to its efficacy and simpler administration.
  • Further randomized controlled trials are needed to confirm these findings, given the retrospective nature and limited patient numbers in this study.