Document Type

Article

Peer Reviewed

1

Publication Date

5-28-2015

NLM Title Abbreviation

BMC Urol.

Journal/Book/Conference Title

BMC Urology

PubMed ID

26018765

DOI of Published Version

10.1186/s12894-015-0039-0

Total Pages

6

Abstract

Background

Urothelial carcinoma (UC) is a common cancer affecting many patients in the United States. Nephroureterectomy remains the gold standard for the treatment of high grade upper tract disease or low grade tumors that are not amenable to endoscopic management. Recent reports have shown a decrease in UC recurrence in patients who underwent nephroureterectomy and who had Mitomycin C (MMC) instilled into the bladder at the time of catheter removal. At our institution instillation of intravesical MMC at the time of nephroureterectomy has been common for more than 10 years. Given the recent data, we sought to formally describe our experience with and evaluate the safety of intravesical instillation of cytotoxic chemotherapy at the time of nephroureterectomy.

Methods

We retrospectively reviewed 51 patients who underwent intraoperative intravesical instillation of cytotoxic chemotherapy (MMC (n = 48) or adriamycin (n = 3)) at the time of nephroureterectomy (2000–2012). The procedure was performed in a similar fashion by 8 different surgeons from the same institution, with drainage of the bladder prior to management of the bladder cuff. Patient characteristics and perioperative data including complications out to 90 days after surgery were collected. Perioperative complications for all patients were graded using the modified Clavien-Dindo classification.

Results

Twenty-four men and 27 women underwent intraoperative intravesical instillation of cytotoxic chemotherapy at the time of nephroureterectomy. Median age at the time of operation was 74 years (range 48–88). Median dwell time was 60 min. Twenty three patients had a total of 45 perioperative complications. The majority (36/45) were Clavien grades I and II. No patients experienced any intraoperative or postoperative complications attributable to MMC or Adriamycin instillation.

Conclusion

Intraoperative intravesical instillation of cytotoxic chemotherapy at the time of nephroureterectomy is safe and feasible. Multicenter trials to study the efficacy of early cytotoxic chemotherapy administration to prevent recurrence of bladder urothelial carcinoma following nephroureterectomy are warranted.

Keywords

OAfund, Carcinoma, Intravesical chemotherapy, Intraoperative mitomycin C, Nephroureterectomy, Urothelial carcinoma

Journal Article Version

Version of Record

Published Article/Book Citation

BMC Urology 2015, 15:45. doi:10.1186/s12894-015-0039-0

Rights

© 2015 Moriarty et al.; licensee BioMed Central.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Included in

Urology Commons

Share

COinS
 

URL

https://ir.uiowa.edu/urology_pubs/3