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2‐micrometer continuous wave laser treatment for multiple non‐muscle‐invasive bladder cancer with intravesical instillation of epirubicin
Author(s) -
Liu Haitao,
Xue Song,
Ruan Yuan,
Sun Xiaowen,
Han Bangmin,
Xia Shujie
Publication year - 2011
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.21014
Subject(s) - medicine , epirubicin , obturator nerve , surgery , urology , urinary system , chemotherapy , radiology , cyclophosphamide
Abstract Background and Objectives We have reported the efficacy and safety of 2‐micrometer continuous wave laser resection of non‐muscle‐invasive bladder tumor (NMIVBC) (World J Urology 2010;28:157–161). In this study, we evaluated the use of 2‐micrometer continuous wave laser resection in combination with intravesical instillation of epirubicin for the treatment of multiple NMIVBC. Materials and Methods From September 2007 to April 2008, sixty patients with multiple NMIVBC were included in this study (44 cases of low grade papillary urothelial carcinoma, 10 cases of high grade papillary urothelial carcinoma, and six cases of papillary urothelial neoplasm with low malignant potential). Imaging examinations including pelvic computer tomography (CT) and intravenous urography showed no extravesical extension, lymphatic metastasis or any lesions of upper urinary tract. All patients received 2‐micrometer continuous wave laser therapy under continuous epidural anesthesia, and intravesical chemotherapy with epirubicin 1 week later (intravesical instillation weekly for 8 weeks, followed by monthly maintenance to 12 months). Results Totally 211 tumors in 60 patients were successfully removed with 2‐micrometer continuous wave laser. The mean operation time was 48 minutes per patient (ranged 20–90 minutes) and 13.6 minutes per tumor (range 5–25 minutes). No obturator nerve reflection or bladder perforation occurred during the procedure. All patients finished 12 months of intravesical chemotherapy without severe complications. The mean followed‐up time was 23 months. Tumor recurrences were found in 13 patients (22%). Conclusions The combination of 2‐micrometer continuous wave laser and intravesical chemotherapy is feasible, safe, and efficacious for the treatment of multiple NMIVBC. Lasers Surg. Med. 43:15–20, 2011. © 2011 Wiley‐Liss, Inc.