AUA 2017: Immediate intravesical chemotherapy for low grade bladder tumors in California: an underutilized practice and its impact on recurrence

Boston, MA ( Neil Pugashetti, University of California at Davis, presented a study assessing utilization trends and recurrence rate of low grade non-muscle invasive bladder cancer (NMIBC). Prior reports suggest decreased use of guideline recommended immediate intravesical chemotherapy (i.e. Mitomycin C (MMC)) after transurethral resection of bladder tumors. However, these reports are often from single or multiple centers. The authors used a large cancer registry to assess population-based use of intravesical chemotherapy and impact on recurrence.

Using the California Cancer Registry from 2005-2012 a total of 10,031 patients with low grade Ta or T1 bladder cancer were identified. They assessed trends and performed multivariate analyses to determine predictors for use as well as calculated recurrence free-survival.

Only 5.1% patients received immediate intravesical chemotherapy which increased over the time period from 1.7% to 9.6%. The recurrence rate at 2 years was 25% and 30% among those that did and did not receive immediate intravesical chemotherapy.
Further studies in larger nationwide databases are needed to confirm these findings and methods to improve adherence to this guideline recommended treatment are needed. Perhaps with the AUA and EAU NMIBC guidelines delineating risk stratification approach to use of immediate postoperative MMC will improve this adherence.

Presented by: Neil Pugashetti, University of California at Davis

Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA

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