Evidence map›Paper›PMID 42639117›Full record

ArticleBladder cancer (Amsterdam, Netherlands)

Intra- and extravesical recurrence after epirubicin-based hyperthermic intravesical chemotherapy (HIVEC) in patients with NMIBC and BCG failure: A multicenter retrospective Observational Study.

Nicolas Arnold, Julien Blanc, Ilaria Lucca, Mihai Dorin Vartolomei, Laila Schneidewind, Nicola Giudici, Raphael Röthlisberger, George N Thalmann, Bernhard Kiss, Beat Roth

Abstract read
In one paragraph

Article in Bladder cancer (Amsterdam, Netherlands). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Nicolas ArnoldDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0009-0006-4122-8249
Julien BlancDepartment of Urology, Lausanne University Hospital, Lausanne, Switzerland.ORCID https://orcid.org/0000-0001-7537-2763
Ilaria LuccaDepartment of Urology, Lausanne University Hospital, Lausanne, Switzerland.ORCID https://orcid.org/0009-0000-4532-7961
Mihai Dorin VartolomeiDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-0359-8517
Laila SchneidewindDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-3409-8654
Nicola GiudiciDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0009-0005-9844-1799
Raphael RöthlisbergerDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-3685-3203
George N ThalmannDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-1908-3286
Bernhard KissDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-4691-556X
Beat RothDepartment of Urology, Inselspital University Hospital Bern, Bern, Switzerland.ORCID https://orcid.org/0000-0002-7369-650X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Guidelines recommend intravesical Bacillus Calmette-Guérin (BCG) as adjuvant therapy for intermediate- and high-risk non-muscle-invasive bladder cancer after transurethral resection. In the event of BCG failure, hyperthermic intravesical chemotherapy (HIVEC) represents a treatment alternative to patients who are surgically inoperable, or decline radical cystectomy. Objective: The aim of this study was to evaluate oncological outcomes in patients receiving epirubicin-based HIVEC as a second-line therapeutic approach. Methods: Retrospective inclusion of patients from our prospectively maintained, multicenter HIVEC database, who underwent HIVEC due to recurrent or persistent high-grade NMIBC following adequate BCG therapy (BCG failure) between November 2016 and December 2024. Survival was evaluated using Kaplan-Meier analysis and log-rank testing. Associations between clinicopathological factors and oncological outcomes were assessed using Cox regression analysis. Results: Sixty-five patients were included. Median follow-up was 38 months (IQR 21-55). Twenty-four patients (36.9%) experienced intravesical recurrence with a median intravesical recurrence-free survival (RFS) of 24 months (IQR 9-45) and 1-/2-year intravesical RFS rates of 77.9% and 64.1%, respectively. Extravesical recurrence was observed in 21 patients (32.3%) with a median extravesical RFS of 22 months (IQR 7-43) and 1-/2-year extravesical RFS rates of 81.3% and 70.9%, respectively. Higher number of recurrences prior to HIVEC were significantly associated with extravesical recurrence in univariate (HR 2.23; 95% CI 1.23-3.87; p=0.019) and multivariate analysis (HR 1.31; 95% CI 1.03-1.67; p=0.027). Conclusions: Although limited by the relatively small sample size, Epirubicin-based HIVEC demonstrated promising oncological outcomes indicating its potential value as bladder-preserving treatment option after BCG failure. Prospective controlled studies are warranted to further assess the role of epirubicin-based HIVEC in this setting.

Indexed as

BCG failurebladder cancercystectomyepirubicinhyperthermic intravesical chemotherapy (HIVEC)progressionrecurrence

Identifiers

PMID42639117
PMCPMC13500795

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.