With 8 years’ median follow-up (range 74-117 months), in a challenging group of 31 highly recurrent NMIBC patients where multiple bladder instillations had failed, BWT resulted in a median 7X extension of the recurrence-free interval (RFI) compared to each patient baseline thus reducing both the pain and cost of 6 surgeries.
Characteristics at baseline: 10/31 high-risk, 21/31 intermediate-risk; median RFI was 5 months (range 3-16 months); median number of recurrences was 5 (range 2-16); all 31 patients failed intravesical BCG, 10 failed also MMC instillations and 6 failed also microwave thermo-chemotherapy instillations.
All 31 patients treated with the same early protocol: there were 6 weekly induction procedures followed by 6 monthly maintenance procedures; drug solution concentration was 40mg MMC in 50ml water, bladder temperature was 44.0-44.5°C and treatment time was 50 minutes.
It’s important to note that today, there are two BWT protocols: A standard one and an enhanced one.
Treatment temperature (44°-44.5°C) and treatment duration (50 min) in current protocols remained the same as in the early protocol.
An #X extension of RFI was calculated for each patient by dividing his post BWT RFI by his baseline RFI. Sixteen patients had no recurrence (of them 7 died recurrence-free, unrelated to bladder cancer) and 15 patients recurred.
30/31 patients benefited from BWT by achieving 2X-26X extended RFI (median 7X).
The RFI extension for each patient is shown in the next page.