Is CIS a Contraindication to Hyperthermic Intravesical Chemotherapy (HIVEC) after BCG-Failure?

Area of Science:

• Urology
• Oncology
• Bladder Cancer Treatment

Background:

• Carcinoma In Situ (CIS) of the bladder presents a high risk of disease progression.
• Radical cystectomy is standard for BCG failure, but bladder-sparing options are needed for ineligible or unwilling patients.

Purpose of the Study:

• To evaluate the efficacy of Hyperthermic IntraVesical Chemotherapy (HIVEC) in non-muscle-invasive bladder cancer (NMIBC) patients post-BCG failure.
• To determine if the presence of concomitant CIS affects treatment outcomes with HIVEC.

Main Methods:

• Retrospective, multicenter study of 116 NMIBC patients with BCG failure treated with 6-8 HIVEC instillations.
• Co-primary endpoints: recurrence-free survival (RFS) and progression-free survival (PFS).
• Analysis compared outcomes between patients with and without CIS.

Main Results:

• Two-year RFS rates were 19.9% with CIS vs. 43.7% without CIS (p=0.52).
• Two-year PFS rates were 71.8% with CIS vs. 88.8% without CIS (p=0.32).
• CIS was not a significant prognostic factor for recurrence or progression in multivariate analysis.

Conclusions:

• CIS is not a contraindication for HIVEC treatment in NMIBC patients post-BCG failure.
• No significant association found between CIS and increased risk of recurrence or progression after HIVEC therapy.