PMID: 2505268Jan 1, 1989Paper

Rationale for intravesical chemotherapy in the treatment and prophylaxis of superficial transitional cell carcinoma

Progress in Clinical and Biological Research
Mark SolowayW M Murphy

Abstract

1. A thorough evaluation of the urinary tract is an integral part of the initial management of a patient with transitional cell carcinoma. The site of all urothelial abnormalities must be determined and adequate histologic material obtained and reviewed. The urothelium not involved by obvious tumor should also be evaluated by either cytology or mucosal biopsies. All patients with high grade tumor should have a biopsy from the prostatic urethra. 2. The clinician should determine the risk of progression by evaluating the tumor grade, stage, and the presence or absence of carcinoma in situ. 3. The likelihood of a recurrence following endoscopic resection of a superficial bladder tumor ranges from 20% for a solitary low grade tumor to over 90% for a patient with multifocal high grade cancer. 4. The reasons for the high incidence of a subsequent tumor include new occurrences related to the continued contact of carcinogens with the susceptible urothelium, failure to completely resect all tumor, and possibly the implantation of tumor cells on the altered urothelial surface following endoscopic resection. 5. Intravesical instillation of antineoplastic agents is capable of reducing the incidence of a subsequent tumor when used for proph...Continue Reading

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