Prognostic Factors Influencing Survival of Patients Receiving Intravesical Epodyl

Abstract

Results from a retrospective analysis of 139 patients with recurrent superficial bladder tumors treated by intravesical epodyl are reviewed. Of the patients who had complete clearance of tumor from the bladder, 95% became free of disease within 12 mo. of starting intravesical therapy. No patient who had persistent tumors at 2 yr was free of tumor subsequently. The majority of complete responders who suffered recurrences did so within 3 yr and 80% of a small series of patients who remained free of tumor after 3 yr and then stopped treatment continued to be free of tumor for a further 2 yr. Failure to respond within 12 mo. or early invasion of the submucosa on biopsy (stage P1b tumors) was associated with poor survival. In patients who underwent salvage cystectomy the demonstration that 35% had involved metastatic lymph nodes and 38% had invasion of muscle is a clear indication of the dangers of delaying radical treatment once the patient has failed to respond completely to intravesical therapy.