TY - JOUR T1 - The Long-Term Effects on Recurrence and Progression of Bladder Tumors of Chemotherapeutic Agents Used After Transurethral Resection TT - Mesane Tümörlerinde Transüretral Rezeksiyondan Sonra Kullanılan Kemoterapötik Ajanların Nüks Ve Progresyon Üzerindeki Uzun Vadeli Etkileri AU - Kıraç, Emre AU - Korğalı, Esat AU - Saygın, Hüseyin AU - Asdemir, Aydemir AU - Ergin, İsmail Emre AU - Öztürk, Abuzer AU - Kır, Adem AU - Velibeyoğlu, Arslan Fatih PY - 2025 DA - May Y2 - 2025 DO - 10.54233/endourolbull-1618269 JF - Endoüroloji Bülteni JO - Endourol Bull PB - Endoüroloji Derneği WT - DergiPark SN - 2148-0532 SP - 61 EP - 70 VL - 17 IS - 2 LA - en AB - Objective: Early single dose chemotherapy may have a reducing effect on recurrence and progression. In this study, we aimed to compare non-muscle invasive patients diagnosed with bladder cancer who did not receive early single dose chemotherapy and those who received intravesical Epirubicin or Gemcitabine in terms of recurrence and progression.Material and Methods: 116 patients were followed up for 48 months (May 2020-June 2022) with diagnosis of primary non-invasive bladder cancer. After transurethral resection of the bladder, patients were followed up with 3 groups: who received intravesical epirubicin, who received gemcitabine, who did not receive any chemotherapeutic agent.Results: The mean age was 63. There were no statistically significant difference in age and, body mass index. Recurrence was determined 57.1% (n=20), 40% (n=18), and 41.7% (n=15) (p=0.263) of the patients, respectively who were not administered any intravesical agent, were administered Epirubicin and, Gemcitabine. While recurrence rates were observed 50%, 25%, 0% (p=0.177) respectively, in low-risk, no progression was detected. In intermediate risk group, 66.7%, 33.3%, 42.8% (p=0.378) recurrence, and 33.3%, 22.7%, 6.7% (p=0.282) progression were detected, respectively. High-risk group, recurrence was found in 56%, 64.2%, 56.2% (p=0.866) of the patients and progression 8%, 14.3%, 6.3% (p=0.723) respectively. In low-grade group, 35.7%, 42.9%, 21.4% (p=0.045) recurrence, and 16.6%, 12.1%, and 4.3% (p=0.164) progression were determined , respectively. In the high-grade group, 58.8%, 50%, 69.2% (p=0.982) recurrence, 5.9%, 16.6% and 7.7% (p=0.581) progression were detected, respectively. Conclusion: These findings demonstrated that intravesical chemotherapeutics can delay or prevent recurrence and progression, should therefore be administered in early postoperative period. Gemcitabine is not in widespread use and has been found to be a good alternative. KW - Bladder cancer KW - Recurrence KW - Progression KW - Epirubicin KW - Gemcitabine N2 - Amaç: Erken tek doz kemoterapinin nüks ve progresyonu azaltıcı etkisi olabilmektedir. Çalışmamızda mesane kanseri tanısı almış, erken tek doz kemoterapi almayan ve intravezikal Epirubisin veya Gemcitabin alan kasa invaziv olmayan hastaların nüks ve progresyon açısından karşılaştırılmasını amaçladık.Gereç ve Yöntemler: Primer non-invaziv mesane kanseri tanısı almış 116 hasta 48 ay (mayıs 2020-haziran 2022) boyunca takip edildi. Mesanenin transüretral rezeksiyonundan sonra hastalar 3 grupta takip edildi: intravezikal epirubisin alanlar, gemcitabin alanlar ve herhangi bir kemoterapi ajanı almayanlar.Bulgular: Olguların ortalama yaşı 63 idi. Hastalarda yaş ve vücut kitle indeksi arasında istatistiksel olarak fark yoktu. Herhangi bir intravezikal ajan uygulanmayan, Epirubisin, Gemcitabine uygulanan hastalarda sırasıyla %57,1 (n=20), %40 (n=18) ve %41,7 (n=15) (p=0,263) oranında nüks saptandı. Düşük riskli grupta nüks oranları sırasıyla %50, %25, %0 (p=0,177) olarak gözlenirken, progresyon saptanmadı. Orta riskli grupta ise sırasıyla %66,7, %33,3, %42,8 (p=0,378) nüks, %33,3, %22,7, %6,7 (p=0,282) oranında progresyon saptandı. Yüksek riskli grupta ise hastaların sırasıyla %56, %64,2, %56,2’sinde nüks (p=0,866), %8, %14,3, %6,3’ünde (p=0,723) progresyon saptandı. Düşük dereceli grupta sırasıyla %35,7, %42,9, %21,4 nüks (p=0,045) ve %16,6, %12,1 ve %4,3 (p=0,164) progresyon saptandı. Yüksek dereceli grupta sırasıyla %58,8, %50, %69,2 nüks (p=0,982), %5,9, %16,6 ve %7,7 (p=0,581) progresyon belirlendi.Sonuç: Bu bulgular, intravezikal kemoterapötiklerin nüks ve progresyonu geciktirebileceğini ve/veya önleyebileceğini, bu nedenle erken postoperatif dönemde uygulanması gerektiğini göstermiştir. Gemsitabin yaygın kullanımda olmayıp alternatif olarak iyi bir tercih olduğu görülmüştür. CR - 1. IARC, Cancer Today. 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Jianglei Zhang, Miao Li, Ze Chen, Jun OuYang, Zhixin Ling, “Efficacy of Bladder Intravezical Chemotherapy with Three Drugs for Preventing Non-Muscle-İnvasive Bladder Cancer Recurrence”, Journal of Healthcare Engineering; 2021 https://doi.org/10.1155/2021/2360717 UR - https://doi.org/10.54233/endourolbull-1618269 L1 - https://dergipark.org.tr/tr/download/article-file/4514165 ER -