Comparison of the Efficacy and Safety of Continuous and Single-Dose Intravesical Epirubicin Instillation

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    Ankara Training and Research Hospital
Updated on 9 April 2023
invasive bladder cancer
transurethral resection
bladder tumor
transurethral bladder excision


In this study, the local and systemic side effects, tumor recurrens and progression rates of single or continuous epirubicin instillation during the early postoperative period were investigated in low and intermediate risk non-muscle-invasive bladder cancer.


Bladder cancer (BC) is the seventh most commonly diagnosed cancer in the male population worldwide, while it drops to tenth when both genders are considered. Worldwide, the BC age-standardised mortality rate (per 100,000 person/years) was 3.3 for men vs. 0.86 for women.It is more common, especially in developed countries. NMIBC are divided into four groups as low-medium-high and very high risk according to EORTC (European Organization for Research and Treatment of Cancer).

Epirubicin is an anthracycline drug used for chemotherapy. Immediate single instillation of epirubicin has been shown to act by destroying circulating tumour cells after TURB(Transurethral Resection of a Bladder Tumor), and by an ablative effect on residual tumour cells at the resection site and on small overlooked tumours.European Association of Urology Guidelines on Bladder Cancer advocates single immediate postoperative intravesical chemotherapy. Early single-dose instillation of epirubicin immediately after transurethral resection was shown to improve recurrence rates in low and intermediate risk groups.

Immediate single instillation of epirubicin into the bladder can induce an array of irritative voiding symptoms including dysuria, frequency, urgency, suprapubic discomfort, hematuria and pelvic pain. In some cases, patients cannot tolerate these symptoms and may necessitate removal of chemotherapeutic agent for alleviation. Incomplete instillation leads to an increase in recurrence and progression rates. In this study, continuous infusion of epirubicin into the bladder and instillation of a single dose epirubicin will be evaluated in terms of side effects, tumor recurrence and progression rates.

Condition Bladder Cancer, Epirubicin Adverse Reaction, Superficial Bladder Cancer, Tumor Recurrence
Treatment Intravesical Solution
Clinical Study IdentifierNCT05084586
SponsorAnkara Training and Research Hospital
Last Modified on9 April 2023


Yes No Not Sure

Inclusion Criteria

Low and intermediate risk NMIBC

Exclusion Criteria

High risk NMIBC
Patients who received intravesical BCG
Postoperative gross hematuria
Bladder perforation
Urinary tract infection
Epirubicin allergy
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