부산대학교 도서관

Simple Summary: Intravesical instillations of BCG remain the standard of care for high-risk non-muscle-invasive bladder cancer (NMIBC). In the case of BCG failure, radical cystectomy is recommended. When patients refuse to undergo BCG or are ineligible due to comorbidities, bladder-sparing techniques can be discussed, the majority of which are still being evaluated. Hyperthermic IntraVEsical Chemotherapy (HIVEC) in patients with carcinoma in situ (CIS) of the bladder remains controversial in terms of its oncological efficacy. In this multicentric retrospective study, including BCG-failed patients treated with HIVEC, we did not find increased recurrence or progression rates in patients with CIS. These data encourage further evaluation of HIVEC for the treatment of non-muscle-invasive bladder carcinoma regardless of the presence of CIS. CIS of the bladder is associated with a high risk of progression. In the case of BCG failure, radical cystectomy should be performed. For patients who refuse or are ineligible, bladder-sparing alternatives are evaluated. This study aims to investigate the efficacy of Hyperthermic IntraVesical Chemotherapy (HIVEC) depending on the presence or absence of CIS. This retrospective, multicenter study was conducted between 2016 and 2021. Patients with non-muscle-invasive bladder cancer (NMIBC) with BCG failure received 6–8 adjuvant instillations of HIVEC. The co-primary endpoints were recurrence-free survival (RFS) and progression-free survival (PFS). A total of 116 consecutive patients met our inclusion criteria of whom 36 had concomitant CIS. The 2-year RFS rate was 19.9% and 43.7% in patients with and without CIS, respectively (p = 0.52). Fifteen patients (12.9%) experienced progression to muscle-invasive bladder cancer with no significant difference between patients with and without CIS (2-year PFS rate = 71.8% vs. 88.8%, p = 0.32). In multivariate analysis, CIS was not a significant prognostic factor in terms of recurrence or progression. In conclusion, CIS may not be considered a contraindication to HIVEC, as there is no significant association between CIS and the risk of progression or recurrence after treatment. [ABSTRACT FROM AUTHOR]