Early adjuvant adriamycin in superficial bladder carcinoma

A multi-center study was performed in 110 patients with superficial transitional cell carcinoma of the bladder. Adriamycin (50 mg/50 ml) was administered intravesically within 24 hours after transurethral resection of TA-T1 (0-A) bladder tumours. Instillation was repeated twice during the first week, then weekly during the first month and then monthly for 1 year. The tolerance was evaluated in these 110 patients and 29 patients presented with local side effects. In 24 of these patients the chemical cystitis was severe enough to drop them out of the study. No systemic side effect was observed. Recurrence was studied on 82 evaluable patients at 1 year of follow up and on 72 patients followed for 2-3 years (mean: 32 months). Of these 82 patients, 23 were primary cases and 59 recurrent. On all 82 patients, 50 did not show any recurrence after 1 year (61%) while 32 presented with one or more recurrences (39%). Of these recurrences, 27 were T1 tumor while 5 progressed to more invasive lesions. In patients that were free of recurrence during the first year, 80% remained tumour free during the 2-3 years follow up period. In patients developing one or more recurrences during the first year, only half of them presented further recurrences once the instillations were stopped. The beneficial effect of Adriamycin appears obvious and might be related to the drug itself, the early and repeated instillations after TUR or both factors.