761 Effectiveness of Chemohypothermia with Mitomycin C vs Immunotherapy with BCG in High Risk Non Muscle Invasive Bladder Cancer Patients

Aim

Initial data to compare the effectiveness of Chemohypothermia with Mitomycin C (MMC) and Immunotherapy with Bacillus-Calmette-Guerin (BCG) in High risk Non muscle invasive bladder cancer (NMIBC).

Method

Sixty six patients who underwent Trans-urethral resection of bladder tumor (TURBT) were divided into two equal groups; hyperthermic intravesical chemotherapy group and BCG group. Six intravesical instillation's (one per week) of 40mg of hyperthermic MMC diluted in 40ml of distill water and heated at 43 C were given to patients for 60 min with HIVEC machine. For BCG group intravesical doses of BCG, once weekly for 6 weeks were administered at concentration of 80mg diluted in 50ml of normal saline. Follow up check cystoscopy at 3 months from initial TURBT was done to check effectiveness of both treatments. Patients were also accessed for side effects during the treatment.

Results

28 patients (84.8%) had no recurrence and 5 patients (15.2%) had recurrence in chemohypethermia group while in BCG group 29(87.8%) patients had no recurrence and 4(12.2%) patients had recurrence.

3(9%) patients had bladder spasms, 1(3%) had hematuria, 3(9.1%) had Urinary tract infection (UTI) while 26(78.8%) had no adverse effect in Chemohyperthermia group. In BCG group, 1(3%) had bladder spasm, 4(12.4%) had hematuria, 5(15.2%) had UTI and 23(69.5%) had no adverse effect.

Conclusions

Chemohyperthermia is safe and efficacious treatment choice in patient suffering from NMIBC with outcomes comparable with BCG treatment and improved side effect profile.