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KMID : 1001020130110030109
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Korean Journal of Urological Oncology
2013 Volume.11 No. 3 p.109 ~ p.115
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Peri-Operative Intravesical Chemotherapy in the Treatment of Non-Muscle Invasive Bladder Cancer: Is It Necessary?
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Kim Myong
Ku Ja-Hyeon
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Abstract
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Peri-operative intravesical instillation of chemotherapy in non-muscle invasive bladder cancer (NMIBC) is one of the options for adjuvant therapy after the transurethral resection of bladder tumor (TURBT). Early instillation is known tosuppress the implantation of tumor cells. Meta-analysis of postoperative immediate instillation of chemotherapy showed that treatment reduced the risk of recurrence up to 39%. Most guidelines recommended the routine application of postoperative immediate instillation within 24 hours after the TURBT in the low- to intermediate-risk NMIBC. However, efficacy of postoperative immediate instillation of chemotherapy in the high-risk NMIBC has not been well established. Although numerous researches implied that postoperative immediate instillation maybe effective, recent randomized controlled trials could not prove it. Therefore, the role of postoperative immediate instillation in the high-risk NMIBC has not been confirmed, although some guidelines also recommend that procedure in this group. The well-designed, large-sized randomized controlled trials are needed to verify this issue.
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KEYWORD
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Urinary bladder neoplasms, Intravesical, Chemotherapy, Recurrence, Disease progression
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