Effect of single and repeated intravesical instillation on prognosis after radical nephroureterectomy in upper urinary tract urothelial carcinoma

Abstract

Abstract:

AIM: To compare the effect and safety between single intravesical chemotherapy and repeated instillation intravesical after radical nephroureterectomy in upper urinary tract urothelial carcinoma (UUT-UC). METHODS: 63 patients were enrolled after radical nephroureterectomy in upper urinary tract urothelial carcinoma from June 2010 to July 2016, and were divided into two groups according to the chemotherapy protocol. 29 patients in single intravesical group (SIG) and 34 patients in repeted instillation intravesical group (RIG). The progression-free survival, overall survival and side effects between two groups were compared.RESULTS: Follow-up was 5-60 months, media follow-up was 36.4 months. The 3-year and 5-year OS in SIG and RIG were 65.5%, 51.7% and 67.6%, 52.9%, respectively. No significant difference was observed between them(P>0.05). Meanwhile, the 3-year and 5-year PFS in SIG and RIG were 79.3%，72.4% and 85.3%，76.5%, there were significant differences between them(P<0.05). The main side effects of two groups were 1-2 grade hematologic toxicity and gastrointestinal reaction. The incidence of hematologic toxicity, digestive tract reaction, bladder spasm and cystitis in RIG were higher than SIG, there were significant difference among them(P<0.05).However, there were no significant difference between liver or kidney damage and fever(P>0.05).CONCLUSION:Using pirarubicin for intravesical instillation is safe and effective for UUT-UC patients after radical nephroureterectomy. Compared with single instillation, repeated instillation chemotherapy can reduce the recurrence rate of bladder cancer, whilst cannot improve the overall survival. Also, repeated instillation cause more severe gastrointestinal and hematologic toxic reactions.

Key words: upper urinary tract urothelial carcinoma, intravesical instillation, repeated instillation, prognosis

CLC Number:

R737

LIAO Guodong, YU Weiwen, ZHANG Qi, LV Jia, MAO Zujie. Effect of single and repeated intravesical instillation on prognosis after radical nephroureterectomy in upper urinary tract urothelial carcinoma[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(4): 461-465.

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