Prophylactic oral methotrexate therapy for multiple superficial bladder carcinoma

Area of Science:

• Oncology
• Urology
• Pharmacology

Background:

• Transitional cell carcinoma (TCC) of the bladder, particularly Ta/T1 stages, frequently recurs.
• Recurrent superficial bladder tumors necessitate ongoing management to prevent progression.

Purpose of the Study:

• To evaluate the efficacy of oral methotrexate in preventing recurrent Ta/T1 transitional cell carcinoma of the bladder.
• To assess the impact of oral methotrexate on tumor recurrence frequency, number, and size.

Main Methods:

• Sixteen patients with multiple, frequently recurring Ta/T1 bladder TCC were enrolled.
• Patients received methotrexate syrup, 50 mg orally, once weekly for 18 months.
• Tumor recurrence rates and characteristics were monitored throughout the treatment period.

Main Results:

• A significant decrease in tumor recurrence was observed in 11 out of 16 patients.
• The average number of tumor recurrences per patient month at risk decreased from 2.6 to 1.2.
• Two patients experienced disease progression requiring cystectomy, while three showed no change in recurrence incidence.

Conclusions:

• Oral methotrexate demonstrates potential as an effective treatment for preventing recurrent superficial bladder carcinoma.
• Methotrexate may serve as a viable alternative to intravesical chemotherapy, offering a different route of administration.
• Further research is warranted to confirm the long-term efficacy and safety of oral methotrexate in this patient population.