Abstract: PD19-05
Sources of Funding: None

Introduction

We have reported the efficacy and safety of continuous saline bladder irrigation (CSBI) after transurethral resection of bladder tumor (TURBT) in low grade non-muscle invasive bladder cancer (NMIBC) (Onishi T et al. AUA 2016 Annual Meeting, BJU Int, 2016). The aim of this study was to evaluate the efficacy and safety of CSBI after TURBT in patients with high grade NMIBC.

Methods

In this prospective randomized study, 226 patients with presumed primary NMIBC eligible for TURBT were enrolled. Patients were randomly allocated to receive CSBI (2,000 ml/h for first 1 hour, then 1,000 ml/h for 2 hours, and then 500 ml/h for 15 hours) or a single immediate instillation of mitomycin C (MMC) after TURBT. The patients with high grade NMIBC were subjected to analyses. Primary end point is recurrence-free survival, and secondary end points were progression-free survival and adverse events.

Results

A total of 147 patients (75 in CSBI group and 72 in MMC group) remained for analysis after exclusion criteria had been applied. The median follow-up period was 36 months. No significant differences in patients’ characteristics were observed between the groups. The 5-year recurrence-free rates for CSBI and MMC were 60.5% (95% confidence interval [CI]: 0.48-0.70) and 67.2% (95% CI: 0.54-0.77), respectively. Kaplan-Meire analysis of recurrence-free survival did not show any significant differences between the groups (log rank test: P=0.56). Furthermore, there were no significant differences between the groups in terms of tumor progression rate and the median time to first recurrence. The incidence of adverse events was significantly lower in CSBI group (8.0% vs 34.7%, P<0.001).

Conclusions

The results show that CSBI after TURBT may be a treatment option even for patients with high grade NMIBC in terms of its prophylactic effect and safety.

Funding

None