표재성 방광암의 재발 및 진행에 대한 고용량 epirubicin과 bacillus Calmette-Guerin 방광 내 주입의 효과 : 전향적 다기관 연구

Abstract

Purpose: To investigate the effects of intravesical high dose epirubicin instillation, the effect of epirubicin was compared with that of Bacillus Calmette-Guerin (BCG) instillation on the recurrence and progression of superficial bladder cancer. Materials and Methods: Between September 1999 and February 2002, a total of 174 patients, who received an 8-week course of high dose epirubicin (80mg/50ml) or a 6-week course of BCG, following a complete transurethral resection for superficial bladder cancer, were followed up. The recurrence-free survival (RFS) and progression-free survival (PFS) rates were analyzed in each groups. Results: There were no significant differences in the overall RFS and PFS between the two groups. In the high risk group, the RFS of the BCG group was significantly higher than that of the epirubicin group (p=0.014), whereas there was no significant difference in the PFS. In the intermediate risk group, there were no significant differences in the RFS and PFS. However, when those patients with a previous history of bladder cancer were excluded, the RFS was significantly higher in the epirubicin group (p= 0.0036). The incidence of local complications was higher in the high dose epirubicin group, but most of these were mild and self-limiting. Conclusions: Intravesical high dose epirubicin instillation in the high risk superficial bladder cancer group had no benefit over that of BCG instillation in terms of RFS and complications. However, high dose epirubicin could be a good alternative for patients in the intermediate risk group and, so it would seem, for those with a first occurrence.