Intravesical instillations for adjuvant treatment of non-muscle-invasive bladder cancer (NMIBC) may be postponed of necessity. However, the frequency and reasons for postponement are unclear.
We carried out a prospective, epidemiological study in an Urology department of the Île-de-France, between August 2016 and March 2017, to determine the frequency and reasons for postponement of intravesical instillations during adjuvant treatment of NMIBC. One-hundred consecutive patients treated by intravesical instillations of mitomycin C (MMC) or Bacillus Calmette-Guérin (BCG) were included. At each session and in case of instillation postponement, the medical team completed a specially designed questionnaire.
A total of 541 instillations were performed in the 100 patients. Twenty-four instillations (4.4%) were postponed in 19 patients. The major cause of postponement was an untreated positive urine analysis and culture (UAC) in 13/24 (54%) cases. The causes of cancellation did not differ significantly between MMC and BCG. The most frequently cancelled instillations were the first in the therapeutic protocol in 26% of cases. The number of instillations preceding those cancelled did not differ significantly between MMC and BCG (2.1±2.0 instillations for MMC vs. 1.5±1.6 for BCG; P=0.64).
There was a low rate of postponed instillations (4.4%). The main reasons, namely an untreated UAC and a positive dipstick test, based on the jurisprudence, are not included in the latest CC-AFU guidelines.
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Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2020 Jan 14 [Epub ahead of print]
W Khan, A S Zugail, E Blanc, Y Neuziller, T Lebret
Department of urology, Foch hospital, University of Versailles, Saint-Quentin-en-Yvelines, Suresnes France. Electronic address: ., Department of surgery, faculty of medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia., Department of urology, Foch hospital, University of Versailles, Saint-Quentin-en-Yvelines, Suresnes France.