EAU Annual Meeting, April 2014
Medical Enterprises thanks the urology colleagues, teams and organizers for the successful EAU congress in Stockholm this month. The congress was very successful and
fruitful. Also many thanks for the new visitors who expressed their interest in
the Synergo system.
2 poster sessions were presented at the EAU meeting this year by Mr. Issa and Mr. Nair from the UK.
Challenging the gold standard: A comparison of long-term disease specific outcomes for high-risk non-muscle invasive bladder cancer treated with mitomycin hyperthermia and radical cystectomy:
A
prospective single-centre review of 96 patients receiving Synergo MMC -HT and
matched against 47 cases undergoing RC for High-Risk Non-Muscle Invasive Bladder
Cancer. Charlson co-morbidity Index (CCI), and peri- and post-procedure
complications were recorded in each group. Post operative pathology, recurrence
and progression rates together with five-year overall and disease specific
survival were evaluated.
The mean CCI
score for patients receiving MMC -HT was
significantly higher than RC group (6.1 vs 4.3). Significant complication rates
classified as a Clavian-Dindo score of greater than 2, was significantly higher
in the RC cohort (21 percent) compared to patients receiving MMC -HT (0
percent).
There were
no deaths associated with MMC -HT
treatment compared to a ninety-day mortality of four percent in those receiving
RC.
Median
follow-up was 36 months (3 to 88 months) for both cohorts. Disease specific
survival at five years was observed at 85.2 and 74.6 percent in the MMC -HT and the
RC cohorts respectively, whilst overall survival figures were 61.9 versus 68.4
percent.
Conclusions: "MMC -HT is both feasible and safe if offered
to well selected patients. It provides durable long-term outcomes compared to
RC for HR-NMIBC.....there is a clear advantage in complication rates favouring MMC -HT over RC without a significant
difference in disease specific or overall survival."
The efficacy and
safety of mitomycin-C hyperthermia in the treatment of high risk (HR)
non-muscle invasive bladder cancer (NMIBC) in a single regional centre.
A report on seven
year experience of MMC -HT, and aim to
establish whether it is efficacious in this high risk cohort of patients.
100 patients with HR NMIBC were treated with MMC -HT (3 patients did not complete
induction regimen due to side effects, 1 patient developed clinical
metastases during the first two weeks of induction course). 96 patients
completed induction treatment and had cystoscopy and biopsy at 3 months.
Of these 96 patients, 84 had failed BCG or were intolerant to it.
Patients were given an induction regimen with weekly treatments for 6-8 weeks
with MMC -H on an outpatient basis with the Synergo® system SB-TS 101.
Median follow up was 34 months (3 to 88 months). 72% of patients (69/96) had complete response at 3 months, 10% had partial response (10/96) and
18% (17/96) had recurrence. Twenty patients
had radical cystectomy. Eighteen patients had organ confined disease and
two patients had T3 disease at histology. Only one patient developed
recurrence of disease after cystectomy. No patients suffered a
Clavien-Dindo Complication above 2.
Conclusions: "MMC-HT has comparable five year survival to radical cystectomy in the treatment of high risk superficial bladder cancer after BCG failure. It is well tolerated and can be delivered effectively by a regional centre. In those patients who are medically fit, cystectomy is still a potentially curative option for those patients who fail MMC-HT."
