BERLIN, GERMANY (UroToday.com) - EAU 2007 - The "Management of Superficial Urothelial Tumors" was presented on Wednesday March 21, 2007 in Berlin Germany.

"Natural Treated History of Patients with Urothelial Carcinoma in Situ" was presented by Dr. Tritschler, Munich, Germany. All patients with CIS diagnosed from 1994-2005 were analyzed regarding whether their CIS was primary, secondary or concurrent and the outcomes of therapy. The cohort consisted of 113 patients and median follow-up was 27.6 months. CIS was primary in 17%, secondary in 20% and concurrent in 61%. All underwent TURBT and about half of all patients received BCG treatment (54 patients) of whom 35 (65%) recurred. 13 of the 35 underwent cystectomy, 2 photodynamic therapy and 3 radiotherapy or chemotherapy. In the entire cystectomy subgroup (n=39), 17 had progression to invasive disease in the observation period. Two patients died of bladder cancer. The presenters confirm that CIS represents a heterogeneous group of patients and that better molecular markers are needed to stratify these patients.

Dr. Witjes, Nijmegen, The Netherlands presented "Intravesical Hyperthermia and Mitomycin-C for BCG Refractory CIS of the Urinary Bladder". Patients were included in the trial if they had CIS, where all papillary disease was maximally resected. The group consisted of 57 patients treated from 1997-2005 at 18 centers. Mean age was 69.5 years and on average patients had 2.9 previous procedures and 40 were previously treated with BCG. Hyperthermia treatment was given with the Synergo® system using a temperature range of 41-44°C. Treatment was 6-8 weeks on an outpatient basis with two 30 minute cycles of MMC. The dosing was twice 20mg for prophylaxis and twice 40mg for therapeutic objectives. Of 48 evaluable patients, 45 had a biopsy and cytology proven complete response. Two patients had resolution of the CIS, but persistent papillary tumors. In 38 complete responders, 12 had recurrences at an average follow-up of 13.6 months (9 of these CIS). This tabulated for a one-year recurrence rate of 30%. Toxicities were mild. The authors are currently assessing this in further studies.

EAU 2007 Conference Coverage on UroToday.com

Written by Christopher P. Evans, MD, a Contributing Editor with UroToday.

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