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Study Questions Epirubicin After Tumor Resection

Single instillation following bladder tumor may only prevent small recurrences that are easily treated

THURSDAY, Dec. 27 (HealthDay News) -- The use of a single instillation of epirubicin after transurethral bladder tumor resection may only prevent small recurrences that could easily be fulgurated with local anesthesia, according to research published in the January issue of the Journal of Urology.

Ingela Berrum-Svennung, of Sahlgrenska University Hospital in Goteborg, Sweden, and colleagues analyzed data from 404 patients who were randomized to receive an instillation of 50 milligrams of epirubicin or placebo after transurethral resection of bladder tumors.

Fifty-one percent of evaluable patients in the treatment group had recurrence compared to 62.5 percent of the placebo group. Most of the recurrences -- 63.3 percent -- were small (1 to 5 millimeters). The researchers found that 8.5 patients needed to be treated to prevent one recurrence, which was in line with previous studies.

"Urologists in the United States have been slow to adapt to the use of perioperative intravesical chemotherapy for low grade, low stage, non-muscle invasive bladder cancer," Michael S. Cookson, M.D., of Vanderbilt University Medical Center in Nashville, Tenn., writes in an accompanying editorial. "However, momentum is shifting and further traction will be gained following publication and dissemination of eagerly anticipated updated American Urological Association Guidelines on the management of superficial bladder cancer, which will include recommendations for perioperative chemotherapy in this setting. The findings of this study question the benefit of single dose perioperative chemotherapy and they require further confirmatory studies."

Berrum-Svennung and co-authors have a financial interest or other relationship with Pfizer.

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