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Ten year follow-up of a randomized prospective study comparing Mitomycin-C and Bacillus Calmette-Guerin in Patients with High Risk Bladder Cancer
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
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Article in journal (Refereed) Submitted
URN: urn:nbn:se:uu:diva-94143OAI: oai:DiVA.org:uu-94143DiVA: diva2:167895
Available from: 2006-03-30 Created: 2006-03-30Bibliographically approved
In thesis
1. Urinary Bladder Carcinoma – Studies of Outcome of Current Management and Experimental Therapy
Open this publication in new window or tab >>Urinary Bladder Carcinoma – Studies of Outcome of Current Management and Experimental Therapy
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The thesis concerns the epidemiology, current and possible future treatment of urothelial cancer of the urinary bladder. The Swedish National Quality Registry for Bladder Cancer 1997-2001 was used to explore epidemiology, current therapies and outcome. More common in men, the incidence for Ta and T1 tumours peaks in the age range 70-79 years. There were differences in treatment activity between the reporting regions. An increasing activity was seen. Older patients received less intravesical treatment, which was also a tendency for women. The five year relative survival for all stages (Ta-T4) was 70%; 93% for Ta and 75% for T1. For Ta or T1 survival did not differ significantly between regions. Because the registry has only been running since 1997 a long term follow-up (ten years) of 250 patients comparing Bacillus Calmette-Guerin and Mitomycin-C, was performed. No differences regarding complementary treatment, progression or survival (overall or disease specific) were shown. Looking for new drugs, gemcitabine was tried for intravesical instillations. Patients were randomised to one of three dose schedules. The effect on a marker tumour lesion was evaluated after nine weeks. The overall complete response rate was 31% (9/29). Side effects were more common in women but generally mild; the most common was nausea. One patient stopped instillations (nausea and fever). No patients were excluded due to pathological changes in laboratory parameters. For metastasised disease, over-expression of the growth factor receptor HER2 on urothelial cancer cells was explored in primary tumours and metastases, aiming at radionuclide target therapy. With a new antigen retrieval procedure and evaluation protocol 80% of primary tumours overexpressed the receptor and 72% remained so in the metastases. In conclusion current therapies were increasingly used by clinicians. Superiority for BCG could not be proven. Prerequisites for new therapies have been explored and the way has been paved for future studies.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 73 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 124
Surgery, Bladder, Epidemiology, Administration, Intravesical, Radiotherapy, Kirurgi
National Category
urn:nbn:se:uu:diva-6634 (URN)91-554-6494-7 (ISBN)
Public defence
2006-04-21, Rudbeck, Rudbeck Laboratory, Rudbeck Laboratory, SE-751 85, Uppsala, 13:15
Available from: 2006-03-30 Created: 2006-03-30Bibliographically approved

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