[Pathological changes associated with topical chemotherapy of adriamycin for bladder cancer]

Since the study of intravesical instillation of thio-TEPA by Jones and Swinney, the method of topical chemotherapy with several anti-cancer drugs for superficial bladder tumors have been reported and it is now an established method of anti-bladder cancer treatment. Adriamycin is one of the most common topical agents against bladder tumor today. We studied the histopathological changes associated with the topical treatment in 26 cases of bladder cancer, all in which either TUR-Bt or cystectomy (partial or radical) had been performed after intravesical instillation of adriamycin. Transurethral biopsies of bladder tumor were done before the chemotherapy, and these findings were histopathologically compared with those of the surgical specimens. In 3 of the 26 cases, the tumors disappeared completely. In the other 23 cases, the main changes were: 1) cellular atrophy of tumor, 2) exfoliation, 3) interstitial hyalinous degeneration, 4) hemorrhage, and 5) dystrophic calcification. These changes are nonspecific of adriamycin, which seems to act as a toxic substance despite its potential activity to inhibit RNA replication.