Contemporary Intravesical Treatment Options for Urothelial Carcinoma of the Bladder

To provide a comprehensive review of intravesical treatment options for non–muscle-invasive bladder cancer, we performed a search of the PubMed database for articles between 1980 and 2006 that reported on intravesical agents for treating this disease. Data were compiled and analyzed, emphasizing findings from large multicenter trials, studies providing reproducible results, data that could be confirmed by cross-referencing the literature, and phase I or II studies for pertinent novel agents. A critical analysis of evidence shows that: 1) treatment with Bacillus Calmette-Guérin (BCG), including a maintenance schedule (with or without interferon-α), is the most effective therapy for limiting recurrence, is the only therapy that reduces the incidence of progression, and overall is superior to chemotherapy; 2) mitomycin C, gemcitabine, anthracyclines, and thiotepa provide similar benefits for preventing recurrence in patients with minimal effect on progression; and 3) using chemotherapeutic agents immediately after transurethral resection (when use of BCG is contraindicated because of the risk for systemic absorption) reduces the recurrence rate by up to 50% and seems to be the ideal method of chemotherapy. Although various clinical factors dictate which agent is most appropriate for an individual patient, the current literature supports a single perioperative dose of intravesical mitomycin C followed, in appropriate cases, by induction and maintenance therapy with intravesical BCG.

If the inline PDF is not rendering correctly, you can download the PDF file here.

Correspondence: Ashish M. Kamat, MD, Department of Urology, Unit 1373, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030. E-mail: akamat@mdanderson.org
  • 1.

    Jemal A, Siegel R, Ward E. Cancer statistics, 2006. CA Cancer J Clin 2006;56:106130.

  • 2.

    Heney NM, Ahmed S, Flanagan MJ. Superficial bladder cancer: progression and recurrence. J Urol 1983;130:10831086.

  • 3.

    Lamm DL, Herr H, Jakse G. Updated concepts and treatment of carcinoma in situ. Urol Oncol 1998;4:130135.

  • 4.

    Abel PD. Follow-up of patients with ``superficial'' transitional cell carcinoma of the bladder: the case for a change in policy. Br J Urol 1993;72:135142.

    • Search Google Scholar
    • Export Citation
  • 5.

    Lamm DL, Blumenstein BA, Crissman JD. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1, and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group study. J Urol 2000;163:11241129.

    • Search Google Scholar
    • Export Citation
  • 6.

    Pearl R. Cancer and tuberculosis. Proc Natl Acad Sci U S A 1929;9:97.

  • 7.

    Morales A, Eidenger D, Bruce AW. Intracavitary bacillus Calmette-Guerin in the treatment of superficial tumors. J Urol 1976;116:180183.

  • 8.

    Ludwig AT, Moore JM, Luo Y. Tumor necrosis factor-related apoptosis-inducing ligand: a novel mechanism for bacillus Calmette-Guérin-induced antitumor activity. Cancer Res 2004;64:33863390.

    • Search Google Scholar
    • Export Citation
  • 9.

    Lamm DL, Thor DE, Harris SC. Bacillus Calmette-Guerin immunotherapy of superficial bladder cancer. J Urol 1980;124:3840.

  • 10.

    Herr HW. Transurethral resection and intravesical therapy of superficial bladder tumors. Urol Clin North Am 1991;18:525528.

  • 11.

    Pagano F, Bassi P, Milani C. Low dose BCG regimen in superficial bladder cancer therapy: is it effective? J Urol 1991;146:3235.

  • 12.

    Melekos MD, Chionis H, Pantazakos A. Intravesical bacillus Calmette-Guerin immunoprophylaxis of superficial bladder cancer: results of a controlled prospective trial with modified treatment schedule. J Urol 1993;149:744748.

    • Search Google Scholar
    • Export Citation
  • 13.

    Krege S, Giani G, Meyer R. A randomized multicenter trial of adjuvant therapy in superficial bladder cancer: transurethral resection only versus transurethral resection plus mitomycin C versus transurethral resection plus bacillus Calmette-Guerin. J Urol 1996;156:962966.

    • Search Google Scholar
    • Export Citation
  • 14.

    Dalbagni G, Herr HW. Superficial bladder cancer: new strategies in diagnosis and treatment. Urol Clin North Am 2000;27:137146.

  • 15.

    Herr HW, Pinsky CM, Whitmore WF Jr. Experience with intravesical bacillus Calmette-Guerin therapy of superficial bladder tumors. Urology 1985;25:119123.

    • Search Google Scholar
    • Export Citation
  • 16.

    Herr HW, Laudone VP, Badalament RA. Bacillus Calmette-Guerin therapy alters the progression of superficial bladder cancer. J Clin Oncol 1988;6:14501455.

    • Search Google Scholar
    • Export Citation
  • 17.

    Sylvester RJ, van der Meijden AP, Lamm DL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol 2002;168:19641970.

    • Search Google Scholar
    • Export Citation
  • 18.

    Coplen DE, Marcus MD, Myers JA. Long-term followup of patients treated with 1 or 2, 6-week courses of intravesical bacillus Calmette-Guerin: analysis of possible predictors of response free of tumor. J Urol 1990;144:652657.

    • Search Google Scholar
    • Export Citation
  • 19.

    Shapiro A, Vakar F, Kamat AM. Diffuse granulomatous mesenteric disease caused by intravesical bacillus Calmette-Guérin instillation masquerading as peritoneal carcinomatosis. Urol Oncol 2005;23:352353.

    • Search Google Scholar
    • Export Citation
  • 20.

    Corti OD, Rivera GP, Aviles JJ. Prophylaxis of superficial bladder cancer with 1 mg of intravesical BCG: comparison with other doses. Actas Urol Esp 1993;17:239242.

    • Search Google Scholar
    • Export Citation
  • 21.

    Martínez-Piñeiro JA, Martínez-Piñeiro L, Solsona E. Has a 3-fold decreased dose of bacillus Calmette-Guerin the same efficacy against recurrences and progression of T1G3 and Tis bladder tumors than the standard dose? Results of a prospective randomized trial. J Urol 2005;174(4 Pt 1):12421247.

    • Search Google Scholar
    • Export Citation
  • 22.

    Sylvester RJ, van der Meijden AP, Witjes JA. Bacillus Calmette-Guerin versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials. J Urol 2005;174:8691.

    • Search Google Scholar
    • Export Citation
  • 23.

    Palou J, Laguna P, Millán-Rodríguez F. Control group and maintenance treatment with bacillus Calmette-Guerin for carcinoma in situ and/or high grade bladder tumors. J Urol 2001;165:14881491.

    • Search Google Scholar
    • Export Citation
  • 24.

    Nadler RB, Catalona WJ, Hudson MA. Durability of the tumor-free response for intravesical bacillus Calmette-Guerin therapy. J Urol 1994;152(2 Pt 1):367373.

    • Search Google Scholar
    • Export Citation
  • 25.

    Badalament RA, Herr HW, Wong GY. A prospective randomized trial of maintenance versus nonmaintenance intravesical bacillus Calmette-Guérin therapy of superficial bladder cancer. J Clin Oncol 1987;5:441449.

    • Search Google Scholar
    • Export Citation
  • 26.

    Hudson MA, Ratliff TL, Gillen DP. Single course versus maintenance bacillus Calmette-Guerin therapy for superficial bladder tumors: a prospective, randomized trial. J Urol 1987;138:295298.

    • Search Google Scholar
    • Export Citation
  • 27.

    Bartoletti R, Massimini G, Criscuolo D. Interferon alpha 2a in superficial bladder cancer prophylaxis: toleration and long-term follow-up. A phase I-II study. Anticancer Res 1991;11:21672170.

    • Search Google Scholar
    • Export Citation
  • 28.

    Portillo J, Martin B, Hernandez R. Results at 43 months follow up of a double-blind, randomized, prospective clinical trial using intravesical interferon alpha-2b in the prophylaxis of stage pT1 transitional cell carcinoma of the bladder. Urology 1997;49:187190.

    • Search Google Scholar
    • Export Citation
  • 29.

    Torti FM, Shortliffe LD, Williams RD. Alpha-interferon in superficial bladder cancer: a Northern California Oncology Group study. J Clin Oncol 1988;6:476483.

    • Search Google Scholar
    • Export Citation
  • 30.

    Glashan RW. A randomized controlled study of intravesical alpha-2b interferon in carcinoma in situ of the bladder. J Urol 1990;144:658661.

    • Search Google Scholar
    • Export Citation
  • 31.

    Engelmann U, Knopf HJ, Graff J. Interferon-alpha 2b installation prophylaxis in superficial bladder cancer—a prospective, controlled three-armed trial: Project Group Bochum—interferon and superficial bladder cancer. Anticancer Drugs 1992;3:3337.

    • Search Google Scholar
    • Export Citation
  • 32.

    Raitanen MP, Lukkarinen O. A controlled study of intravesical epirubicin with or without alpha 2b-interferon as prophylaxis for recurrent superficial transitional cell carcinoma of the bladder: Finnish Multicentre Study Group. Br J Urol 1995;76:697701.

    • Search Google Scholar
    • Export Citation
  • 33.

    Jimenez-Cruz JT, Vera-Donoso CD, Leiva O. Intravesical immunoprophylaxis in recurrent superficial bladder cancer (stage T1): multicenter trial comparing bacillus Calmette-Guerin and interferon-alpha. Urology 1997;50:529535.

    • Search Google Scholar
    • Export Citation
  • 34.

    O'Donnell MA, Krohn J, DeWolf WC. Salvage intravesical therapy with interferon alpha-2b plus low dose bacillus Calmette-Guerin is effective in patients with superficial bladder cancer in whom bacillus Calmette-Guerin alone previously failed. J Urol 2001;166:13001304.

    • Search Google Scholar
    • Export Citation
  • 35.

    Punnen SP, Chin JL, Jewett MA. Management of bacillus Calmette-Guerin (BCG) refractory superficial bladder cancer with intravesical BCG and interferon combination therapy. Can J Urol 2003;10:17901795.

    • Search Google Scholar
    • Export Citation
  • 36.

    Luciani LG, Neulander E, Murphy WM. Risk of continued intravesical therapy and delayed cystectomy in BCG-refractory superficial bladder cancer: an investigational approach. Urology 2001;58:376379.

    • Search Google Scholar
    • Export Citation
  • 37.

    O'Donnell MA, Lilli K, Leopold C. National Bacillus Calmette-Guerin/Interferon Phase 2 Investigator Group: interim results from a national multicenter phase II trial of combination bacillus Calmette-Guerin plus interferon alfa-2b for superficial bladder cancer. J Urol 2004;172:888893.

    • Search Google Scholar
    • Export Citation
  • 38.

    Jurincic CD, Engelmann U, Gasch J. Immunotherapy in bladder cancer with keyhole-limpet hemocyanin: a randomized study. J Urol 1988;139:723726.

    • Search Google Scholar
    • Export Citation
  • 39.

    Kalble T, Mohring K, Ikinger U. Intravesical prevention of recurrence of superficial urinary bladder cancer with BCG and KLH. A prospective randomized study. Urologe A 1991;30:118121.

    • Search Google Scholar
    • Export Citation
  • 40.

    Witjes WP, Konig M, Boeminghaus FP. Results of a European comparative randomized study comparing oral bropirimine versus intravesical BCG treatment in BCG-naïve patients with carcinoma in situ of the urinary bladder: European Bropirimine Study Group. Eur Urol 1999;36:576581.

    • Search Google Scholar
    • Export Citation
  • 41.

    Sarosdy MF, Tangen CM, Weiss GR. A phase II clinical trial of oral bropirimine in combination with intravesical bacillus Calmette-Guérin for carcinoma in situ of the bladder: a Southwest Oncology Group Study. Urol Oncol 2005;23:386389.

    • Search Google Scholar
    • Export Citation
  • 42.

    Grasso M, Torelli F, Scannapieco G. Neoadiuvant treatment with intravesical interleukin-2 for recurrent superficial transitional bladder carcinoma Ta-T1/G1-2. J Immunother 2001;24:184187.

    • Search Google Scholar
    • Export Citation
  • 43.

    Clinton SK, Canto E, O'Donnell MA. Interleukin-12. Opportunities for the treatment of bladder cancer. Urol Clin North Am 2000;27:147155.

  • 44.

    Weiss GR, O'Donnell MA, Loughlin K. Phase 1 study of the intravesical administration of recombinant human interleukin-12 in patients with recurrent superficial transitional cell carcinoma of the bladder. J Immunother 2003;26:343348.

    • Search Google Scholar
    • Export Citation
  • 45.

    Glazier DB, Bahnson RR, McLeod DG. Intravesical recombinant tumor necrosis factor in the treatment of superficial bladder cancer: an Eastern Cooperative Oncology Group study. J Urol 1995;154:6668.

    • Search Google Scholar
    • Export Citation
  • 46.

    Stravoravdi P, Toliou T, Kirtsis P. A new approach in the management of urothelial tumors using GM-CSF on marker lesions: an ultrastructural and immunohistochemical study on the macrophage population in bladder mucosa. J Interferon Cytokine Res 1999;19:221225.

    • Search Google Scholar
    • Export Citation
  • 47.

    Filion MC, Phillips NC. Therapeutic potential of mycobacterial cell wall-DNA complexes. Expert Opin Investig Drugs 2001;10:21572165.

  • 48.

    Morales A, Chin JL, Ramsey EW. Mycobacterial cell wall extract for the treatment of carcinoma in situ of the bladder. J Urol 2001;166:16331637.

    • Search Google Scholar
    • Export Citation
  • 49.

    Zlotta AR, Schulman CC. Biological response modifiers for the treatment of superficial bladder tumors. Eur Urol 2000;37:1015.

  • 50.

    Elsässer-Beile U, Leiber C, Wolf P. Adjuvant intravesical treatment of superficial bladder cancer with a standardized mistletoe extract. J Urol 2005;174:7679.

    • Search Google Scholar
    • Export Citation
  • 51.

    Yan X, Ding Q, Zhang YF, Xu YH. Inhibitory effect of recombinant transforming growth factor alpha-pseudomonas exotoxin 40 on human bladder cancer cell proliferation. Zhonghua Wai Ke Za Zhi 2004;42:14571459.

    • Search Google Scholar
    • Export Citation
  • 52.

    Messing EM, Catalona W. Urothelial tumors of the urinary tract. In: Walsh PC, Retik AB, Vaughan ED Jr, et al., eds. Campbell's Urology, 7th ed. Philadelphia: WB Saunders, 1998:23272410.

    • Search Google Scholar
    • Export Citation
  • 53.

    Mostafid AH, Rajkumar RG, Stewart AB, Singh R. Immediate administration of intravesical mitomycin C after tumour resection for superficial bladder cancer. BJU Int 2006;97:509512.

    • Search Google Scholar
    • Export Citation
  • 54.

    Tolley DA, Parmar MK, Grigor KM. The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of follow up. J Urol 1996;155:12331238.

    • Search Google Scholar
    • Export Citation
  • 55.

    Conrad S, Friedrich MG, Schwaibold H. Long-term prophylaxis with mitomycin C (MMC) further reduces tumor recurrence compared to short-term prophylaxis with MMC or bacillus Calmette-Guerin (BCG). J Urol 2004;171:71A.

    • Search Google Scholar
    • Export Citation
  • 56.

    Kurth KH, Bouffioux C, Sylvester R. Treatment of superficial bladder tumors: achievement and needs. Eur Urol 2000;37[Suppl 3]:19.

  • 57.

    Bohle A, Jocham D, Bock PR. Intravesical BCG versus mitomycin C for superficial bladder cancer: a formal meta-analysis of comparative studies on recurrence and toxicity. J Urol 2003;169:9095.

    • Search Google Scholar
    • Export Citation
  • 58.

    Bohle A, Bock PR. Intravesical BCG versus mitomycin C in superficial cancer: formal meta-analysis of comparative studies on tumor progression. Urology 2004;63:682686.

    • Search Google Scholar
    • Export Citation
  • 59.

    Sylvesteer RJ, Adrian PM, van der Meijden J. BCG versus chemotherapy for the intravesical treatment of patients with carcinoma in situ of the bladder: a meta-analysis of the published results of randomized clinical trials. J Urol 2005;175:8692.

    • Search Google Scholar
    • Export Citation
  • 60.

    Huncharek M, Kupelnick B. The influence of intravesical therapy on progression of superficial transitional cell carcinoma of the bladder: a metaanalytic comparison of chemotherapy versus bacilli Calmette-Guerin immunotherapy. Am J Clin Oncol 2004;27:522528.

    • Search Google Scholar
    • Export Citation
  • 61.

    Duque JL, Loughlin KR. Superficial bladder cancer: new strategies in diagnosis and treatment. Urol Clin North Am 2000;27:125135.

  • 62.

    Au JL, Badalament RA, Wientjes G. Methods to improve efficacy of intravesical mitomycin C: results of a randomised phase III trial. J Natl Cancer Inst 2001;93:597604.

    • Search Google Scholar
    • Export Citation
  • 63.

    Di Stasi SM, Giannantoni A, Stephen RL. Intravesical electromotive mitomycin C versus passive transport mitomycin C for high risk superficial bladder cancer: a prospective randomised study. J Urol 2003;170:777782.

    • Search Google Scholar
    • Export Citation
  • 64.

    Gofrit ON, Shapiro A, Pode D. Combined local bladder hyperthermia and intravesical chemotherapy for the treatment of high grade superficial bladder cancer. Urology 2004;63:466471.

    • Search Google Scholar
    • Export Citation
  • 65.

    Rintala E, Jauhiainen K, Rajala P. Alternating mitomycin-C and bacillus Calmette-Guerin instillation therapy for carcinoma in situ of the bladder. J Urol 1995;154:20502053.

    • Search Google Scholar
    • Export Citation
  • 66.

    Rintala E, Jauhiainen K, Kaasinen E. Alternating mitomycin C and bacillus Calmette-Guerin instillation prophylaxis for recurrent papillary (stages Ta to T1) superficial bladder cancer. J Urol 1996;156:5659.

    • Search Google Scholar
    • Export Citation
  • 67.

    Witjes JA, Caris CT, Mungan NA. Results of a randomised phase III trial of sequential intravesical therapy with mitomycin C and bacillus Calmette-Guerin versus mitomycin C alone in patients with superficial bladder cancer. J Urol 1998;160:16681671.

    • Search Google Scholar
    • Export Citation
  • 68.

    Kaasinen E, Wijkstrom H, Malmstrom PU. Alternating mitomycin C and BCG instillations versus BCG alone in treatment of carcinoma in situ of the urinary bladder: a Nordic study. Eur Urol 2003;43:637645.

    • Search Google Scholar
    • Export Citation
  • 69.

    Di Stasi SM, Giannantoni A, Giurioli A. Sequential BCG and electromotive mitomycin versus BCG alone for high-risk superficial bladder cancer: a randomised controlled trial. Lancet Oncol 2006;7:4351.

    • Search Google Scholar
    • Export Citation
  • 70.

    Kaasinen E, Rintala E, Hellstrom P. Factors explaining recurrence in patients undergoing chemoimmunotherapy regimens for frequently recurring superficial bladder carcinoma. Eur Urol 2002;42:167174.

    • Search Google Scholar
    • Export Citation
  • 71.

    Xin Y, Lyness G, Chen D. Low dose suramin as a chemosensitizer of bladder cancer to mitomycin C. J Urol 2005;174:322327.

  • 72.

    Bouffioux C, Kurth KH, Bono A. Intravesical adjuvant chemotherapy for superficial transitional cell bladder carcinoma: results of 2 European Organization for Research and Treatment of Cancer randomized trials with mitomycin C and doxorubicin comparing early versus delayed instillations and short-term versus long-term treatment. European Organization for Research and Treatment of Cancer Genitourinary Group. J Urol 1995;153:934941.

    • Search Google Scholar
    • Export Citation
  • 73.

    Dalbagni G, Russo P, Sheinfeld J. Phase I trial of intravesical gemcitabine in bacillus Calmette-Guerin-refractory transitional-cell carcinoma of the bladder. J Clin Oncol 2002;20:31933198.

    • Search Google Scholar
    • Export Citation
  • 74.

    Dalbagni G, Mazumdar M, Russo P. Phase II trial of intravesical gemcitabine in BCG-refractory transitional cell carcinoma of the bladder [abstract]. J Urol 2004;171:Abstract 274A.

    • Search Google Scholar
    • Export Citation
  • 75.

    O'Donnell MA. Practical applications of intravesical chemotherapy and immunotherapy in high-risk patients with superficial bladder cancer. Urol Clin North Am 2005;32:121131.

    • Search Google Scholar
    • Export Citation
  • 76.

    Ali-el-Dein B, el-Baz M, Aly AN. Intravesical epirubicin versus doxorubicin for superficial bladder tumors (stages pTa and pT1): a randomized prospective study. J Urol 1997;158:6873.

    • Search Google Scholar
    • Export Citation
  • 77.

    Kurth K, Tunn U, Ay R. Adjuvant chemotherapy for superficial transitional cell bladder carcinoma: long-term results of a EORTC randomized trial comparing doxorubicin, ethoglucid, and TUR alone. J Urol 1997;158:378384.

    • Search Google Scholar
    • Export Citation
  • 78.

    Oosterlinck W, Kurth KH, Schroder F. A prospective European Organization for Research and Treatment of Cancer Genitourinary Group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single state Ta, T1 papillary carcinoma of the bladder. J Urol 1993;149:749752.

    • Search Google Scholar
    • Export Citation
  • 79.

    Rajala P, Kaasinen E, Raitanen M. Perioperative single dose instillation of epirubicin or interferon-α after transurethral resection for the prophylaxis of primary superficial bladder cancer recurrence: a prospective randomized multicenter study-FinnBladder III long-term results. J Urol 2002;168:981985.

    • Search Google Scholar
    • Export Citation
  • 80.

    Steinberg G, Bahnson R, Brosman S. Efficacy and safety of valrubicin for the treatment of bacillus Calmette-Guerin refractory carcinoma in situ of the bladder: the Valrubicin Study Group. J Urol 2000;163:761767.

    • Search Google Scholar
    • Export Citation
  • 81.

    Isaka S, Okano T, Abe K. Sequential instillation therapy with mitomycin C and adriamycin for superficial bladder cancer. Cancer Chemother Pharmacol 1992;30:4144.

    • Search Google Scholar
    • Export Citation
  • 82.

    Sekine H, Ohya K, Kojima SI. Equivalent efficacy of mitomycin C plus doxorubicin instillation to bacillus Calmette-Guerin therapy for carcinoma in situ of the bladder. Int J Urol 2001;8:483486.

    • Search Google Scholar
    • Export Citation
  • 83.

    Fukui I, Kihara K, Sekine H. Intravesical combination chemotherapy with mitomycin C and doxorubicin for superficial bladder cancer: a randomized trial of maintenance versus no maintenance following a complete response. Cancer Chemother Pharmacol 1992;30:3740.

    • Search Google Scholar
    • Export Citation
  • 84.

    Wirger A, Perabo FG, Burgemeister S. Flavopiridol, an inhibitor of cyclin-dependent kinases, induces growth inhibition and apoptosis in bladder cancer cells in vitro and in vivo. Anticancer Res 2005;25:43414347.

    • Search Google Scholar
    • Export Citation
  • 85.

    Lamm DL, Riggs DR. The potential application of Allium sativum (garlic) for the treatment of bladder cancer. Urol Clin North Am 2000;27:157162.

    • Search Google Scholar
    • Export Citation
  • 86.

    Hsieh JT, Dinney CP, Chung LW. The potential role of gene therapy in the treatment of bladder cancer. Urol Clin North Am 2000;27:103113.

  • 87.

    Benedict WF, Tao Z, Kim CS. Intravesical Ad-IFNalpha causes marked regression of human bladder cancer growing orthotopically in nude mice and overcomes resistance to IFN-alpha protein. Mol Ther 2004;10:525532.

    • Search Google Scholar
    • Export Citation
  • 88.

    Gomella LG, Mastrangelo MJ, McCue PA. Phase I study of intravesical vaccinia virus as a vector for gene therapy of bladder cancer. J Urol 2001;166:12911295.

    • Search Google Scholar
    • Export Citation
  • 89.

    Le Visage C, Rioux-Leclercq N, Haller M. Efficacy of paclitaxel released from bio-adhesive polymer microspheres on model superficial bladder cancer. J Urol 2004;171:13241329.

    • Search Google Scholar
    • Export Citation
  • 90.

    Divrik RT, Yildirim U, Zorlu F. The effect of repeat transurethral resection on recurrence and progression rates in patients with T1 tumors of the bladder who received intravesical mitomycin: a prospective, randomized clinical trial. J Urol 2006;175:16411644.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 109 94 1
PDF Downloads 26 21 1
EPUB Downloads 0 0 0