CU 03. Prophylactic intravesical chemotherapy after nephrourecterectomy for primary upper urinary tract urothelial carcinomas to prevent bladder tumors: A systematic review and meta - analysis

Purpose: We determined if prophylactic intravesical chemotherapy after nephrourecterectomy for primary upper tract urothelial carcinomas decreases the risk of bladder recurrence.

Materials and Methods: A meta-analysis was performed of the published results of clinical tr ials compar ing nephrourecterectomy alone to nephrourecterectomy plus postoperative instillation of chemotherapy for primary upper tract urothelial carcinomas.

Results: Our study included 3 trials with recurrence information of 460 patients. During followup 40 of 191 patients (20.9%) receiving postoperative instillation of mitomycin C, epirubicin, or mitomycin C plus arabinoside had bladder recurrence compared to 94 of 269 (34.9%) patients that had no adjuvant treatment, a decrease of 35% in the odds of recurrence with chemotherapy (OR 0.55, 95% CI 0.35-0.85, P=0.008). No serious adverse events were reported. Subgroup analyses were temporarily unavailable.

Conclusions: Postoperative intravesical chemotherapy significantly decreases the risk of bladder recurrence after nephrourecterectomy for primary upper tract urothelial carcinomas.