Journal article
Practical applications of intravesical chemotherapy and immunotherapy in high-risk patients with superficial bladder cancer
Urologic clinics of North America, Vol.32(2), pp.121-131
05/2005
DOI: 10.1016/j.ucl.2005.01.003
PMID: 15862610
Abstract
The following steps are practical in the treatment of intermediate-to-high risk patients with superficial bladder cancer: Resect all visible tumor at the time of first TUR of bladder tumor. Strongly consider re-resection, especially for high-risk, large, multifocal, stage T1 tumors. Apply one dose of cytotoxic chemotherapy perioperatively within 6 hours of TUR (ideally immediately). Once histopathology is available, consider intravesical induction chemotherapy for intermediate-risk patients and BCG for intermediate- or high-risk patients and those having failed prior chemotherapy. At least 1 year of maintenance therapy should be planned for all intermediate-to-high risk BCG-treated patients. Chemotherapy maintenance may be useful if perioperative chemotherapy was omitted. For patients failing standard therapy, a thorough discussion of the risks (including progression and metastasis) and expected benefits should take place before the initiation of salvage therapy. The radical cystectomy option should be openly entertained. Consider BCG plus interferon or gemcitabine-based salvage programs if appropriate. Explore clinical trial options. Contact urologic cancer experts for guidance and advice.
Details
- Title: Subtitle
- Practical applications of intravesical chemotherapy and immunotherapy in high-risk patients with superficial bladder cancer
- Creators
- Michael A O'Donnell - Department of Urology, University of Iowa College of Medicine, Iowa City, IA 52242-1009, USA. michael-odonnell@uiowa.edu
- Resource Type
- Journal article
- Publication Details
- Urologic clinics of North America, Vol.32(2), pp.121-131
- Publisher
- United States
- DOI
- 10.1016/j.ucl.2005.01.003
- PMID
- 15862610
- ISSN
- 0094-0143
- eISSN
- 1558-318X
- Language
- English
- Date published
- 05/2005
- Academic Unit
- Urology
- Record Identifier
- 9984051574002771
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