AUA 2017: The Benefit of Continuous Saline Bladder Irrigation After Transurethral Resection in High-Grade Non-Muscle-Invasive Bladder Cancer: A Single-Center, Randomized, Prospective Study
A total of 236 patients were randomized. After exclusion, however, 76 and 74 patients were randomized to CSBI versus MMC, respectively. The primary endpoint was recurrence-free survival. Secondary endpoints were progression-free survival and adverse events. All patients underwent similar surveillance, with none of them receiving further treatments until first recurrence was noted.
There was no significant difference in recurrence-free survival. Moreover, there was no difference in progression-free survival. There was significantly decreased adverse events noted in the CSBI versus MMC group (8% vs. 38%, P < .001), respectively. The authors concluded that CSBI was not inferior to MMC and may be a safe and less costly alternative in patients with high-grade NMIBC.
The findings must now be interpreted in the context of the study design. First, the duration of CSBI required patients to be admitted overnight, which carries significant costs considering many patients often undergo TURBT as an outpatient procedure. The authors indicated that the hospital stay was the same for both groups. Second, the MMC used in this trial was 30 mg whereas 40 mg is guideline-recommended. Third, current American Urological Association and European Association of Urology guidelines do not suggest MMC in patients with intermediate-to-high-risk NMIBC. Thus, the present findings may not be applicable.
Presented By: Takehisa Onishi, MD, Ise Red Cross Hospital, Ise, Japan
Written By: Stephen B. Williams, MD, Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX, and Ashish M. Kamat, MD Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA