Kamat - Figure 29
Hyperthermic Mitomycin Post BCG
FIG. 29: The risk stratification of patients with recurrent tumor after BCG has been applied in several real-world scenarios. A study of combined bladder wall hyperthermia and mitomycin (thermo-chemotherapy) post-BCG in patients who had had tumor recurrences after BCG therapy showed disease-free survival of 85% at 1 year and 56% at 2 years – which are very good results.[26] However, if we recognize the importance of the substratification of BCG failures, we can see that only 30% of these patients were truly BCG refractory and only 17% had relapsed within 12 months of BCG. So this treatment is potentially effective, but it may not be effective in the BCG-unresponsive subgroup of patients or the ones in whom we are trying to avoid radical cystectomy.
[Legend: Left graph – highly recurrent disease, high risk (blue curve) vs other (green curve); right graph – high recurrent disease, high risk (blue curve) vs intermediate risk (green curve).]
References
Nativ O, Witjes JA, Hendricksen K, et al. Combined thermo-chemotherapy for recurrent bladder cancer after bacillus Calmette-Guerin. J Urol. 2009;182:1313−7 http://dx.doi.org/10.1016/j.juro.2009.06.017
