The Clinical Study Of Intra-arterial Chemotherapy Followed By Bladder-preserving Surgery For High-risk Non Muscle-invasive Bladder Cancer

Objective : To study the efficacy of intra-arterial chemotherapy followed by bladder-preserving surgery for high-risk non muscle-invasive bladder cancer(NMIBC)Methods : From January 2012 to December 2014,58 patients which were all diagnosed with NMIBC by bladder-preserving surgery(TURBT or partial cystectomy) randomly divided into 2 groups, 27 patients(age 34-87 years,22 male and 5 female) were given intra-arterial chemotherapy( gemcitabine + cisplatin + epirubicin) combined with intravesical chemotherapy(epirubicin or THP), and 31 patients(51- 90 years,29 male and 2 female) received intravesical chemotherapy alone,recurrence rate, progression rate, time to first recurrence, tumor progression-free survival rate, and adverse reactions were compared between two groupsResults:After 10-46 months(median,25months) followed-up, the recurrence rate of the intra-arterial chemotherapy(mean,23.7months) and the intravesical chemotherapy(mean,25.7months) groups were 3.7%(1/27) and 32.3%(10/31),respectively. The no tumor recurrence survival time of the two groups were 38.2±0.8 months and 29.7±2.3 months respectively. The overall recurrence-free rate were 95.7%、37.0%(p=0.006) of the two groups. The progression rate were 0.0%(0/27)and 16.7%(5/31), respectively. The tumor progression-free survival rate were 100%、66.7%(P=0.03)Conclusions : This study suggest that intra-arterial chemotherapy followed by bladder-preserving surgery for NIMBC is more effective in preventing from recurrence and progression compared with intravesical chemotherapy alone.