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Pirarubicin instilled intravesically reduced bladder recurrence after nephroureterectomy
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A single early intravesical instillation of pirarubicin yielded significant reductions in bladder recurrence rates in a cohort of patients with urothelial carcinoma, study results showed.
The researchers investigated whether the pirarubicin instillation could prevent recurrence in the bladder after nephroureterectomy for upper urinary tract urothelial carcinoma in a cohort of 77 patients from 11 institutions in Japan.
Diagnoses occurred between December 2005 and November 2008.
The final analysis included 36 patients who were randomly assigned a single instillation of pirarubicin (30 mg in 30 mL of saline) into the bladder 48 hours after nephroureterectomy, and 36 controls who did not receive this treatment.
Clinicians performed cytoscopy and urinary cytology every 3 months for 2 years or until recurrence.
There were 21 bladder recurrences in the cohort.
Recurrence rates were lower in the study drug group than the nontreatment group at both 1 year (16.9% vs. 31.8%) and 2 years (16.9% vs. 42.2%; log rank P=.025).
The treatment was not associated with any remarkable adverse events, according to researchers.
Multivariable analysis results indicated that pirarubicin instillation (HR=0.26; 95% CI, 0.07-0.91) and open surgery (HR=0.28; 95% CI, 0.09-0.84) independently predicted a decreased likelihood of bladder recurrence.
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