ISSN:
0730-2312
Keywords:
intravesical therapy
;
superficial bladder cancer
;
transitional cell carcinoma
;
Life and Medical Sciences
;
Cell & Developmental Biology
Source:
Wiley InterScience Backfile Collection 1832-2000
Topics:
Biology
,
Chemistry and Pharmacology
,
Medicine
Notes:
Approximately 70% of all bladder cancers are superficial at the time of presentation. Superfecial bladder cancer includes tumors confined to the urothelium (clinical stage Ta) or lamina propria (stage T1) and flat carcinoma is situ (stage Tis). Because the biological behavior of bladder neoplasms is variable, several important prognostic factros must be addressed. Multivariate analyses have shown that factors predictive of tumor recurrence and tumor progression include multifocal tumors, high grade tumors. T1 tumors and positive urinary cytology after transurethral resection (TUR). The patient with superficial bladder cancer should be monitored via endoscopy supplemented by urinary cytology, using either voided or bladder irrigation specimens and urinalysis. Frequent intravenous urography is not required, even in high grade tumors, as long as the clinical and pathologic studies remain negative and the patient is asymptomatic.The “gold standard” of treatment for superficial is TUR of the entire tumor. Despite TUR, new tumors will occur in approximately 50% of all patients; those at highest risk for tumor recurrence and progression require adjuvant intravesical therapy after TUR. A variety of drugs are used as intravesical therapy, including thiotepa, mitomycin C, doxorubicin hydrochloride, Bacillus Calmette-Guerin (BCG), epirubicin, and interferon. Although associated with the most toxicity, BCG appears to be the most effecacious agent in increasing the time to recurrence and progression and in reducing the recurrence rate. © 1992 Wiley-Liss, Inc.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1002/jcb.240501323
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