Early adjuvant adriamycin in superficial bladder carcinoma

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Abstract
Summary A multicenter study was performed in 110 patients with superficial transitional cell carcinoma of the bladder. Adriamycin (50 mg/50 ml) was administered intravesically within 24 h after transurethral resection of TA-T1 (O-A) bladder tumors. Instillation was repeated twice during the first week, then weekly during the first month, and monthly for 1 year. Tolerance was evaluated in these 110 patients and 29 patients presented with local side effects. In 24 of these patients the chemical cystitis was severe enough to cause them to drop out of the study. No systemic side effect was observed. Recurrence was studied in 82 evaluable patients at 1 year of follow-up and on 72 patients followed for 2–3 years (mean: 32 months). Of these 82 patients, 23 were primary cases and 59 recurrent. In all 82 patients, 50 (61%) did not show any recurrence after 1 year, while 32 (39%) presented with one or more recurrences. Of these recurrences, 27 were T1 tumors while 5 progressed to more invasive lesions. In patients that were free of recurrence during the first year, 80% remained tumor-free during the 2–3 year follow-up period. In patients who had developed one or more recurrences during the first year, only half of them developed further recurrences once the instillations were stopped. The beneficial effect of adriamycin appears obvious and might be related to the drug itself, the early and repeated instillations after TUR, or both factors.