This investigation compares the short and long-term administration of intravesical
Epodyl (
etoglucid), following transurethral
bladder tumor resection. This chemoprophylactic agent was used specifically in the treatment of
bladder tumors that displayed different associated
tumor risk factors: solitary versus multiple
tumors, grade(s) I-III, primary versus recurrent
tumors, and the presence of associated dysplasia. Within this study, 114 patients with
carcinoma of the bladder underwent primary transurethral resection (TUR), followed in 10 days by short-term intravesical
therapy (STIT) or long-term intravesical
therapy (LTIT). Short-term intravesical
therapy was administered to 56 patients. The
therapy consisted of a 1%
solution of
Epodyl, which was given once per week for 6 weeks. Long-term intravesical
therapy was given to 58 patients. This consisted of the short-term intravesical
therapy protocol, followed by an additional dose once a month during an observation period of 2 years. The follow-up in both groups was for a minimum of 2 years. When the total number of recurrences in patients receiving (STIT) or (LTIT) was compared, no marked differences were noted (39% vs 38%). However, there was a difference when the individual
tumor risk features were compared, e.g. for solitary
tumors, the recurrence rate was 67% within the (STIT) group and 43% within the (LTIT). These results demonstrate that the decision of whether superficial bladder
carcinomas are to be treated with short- or long-term
Epodyl should be based on
tumor-associated risk factors. Furthermore, if multiple
tumor risk factors are present, maximal
therapy is require; in the absence of risk factors TUR alone may be sufficient.