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Ureteropyeloscopy was used to follow-up two patients with upper urinary tract transitional cell tumours treated by topical chemotherapy. Epodyl was instilled into the pelvis and ureter through a ureteric catheter. There were no complications. The ureteric tumours responded completely, whereas a pelvic papilloma diminished in size to about 1 mm.
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Cytotoxic chemotherapy is used increasingly in the management of bladder cancer. The agents used, intravesically and systemically, are reviewed, together with preliminary reports of certain trials of adjuvant chemotherapy that have now been activated.
First prognostic factors which are relevant for the variable course of bladder carcinoma like histological grading, blood group antigens and multiplicity of bladder tumors are discussed. Furthermore, therapy and recidive prophylaxis of not infiltrating carcinoma by intravesical cytostatic chemotherapy are discussed. In contrast to Thiotepa, a substance which has now been used for 20 years by many oncologists and should not be used any more because of very frequent systemic toxicity and only variable effects against the tumor, Adriamycin, Mitomycin C and Epodyl reduce the frequency of recidives used as prophylactic therapy after transurethral resection. With these substances pronounced systemic toxicity has not been seen until now. Cisdiaminodichloroplatin is a cytostatic agent which is also effective used systemically in cases with generalized bladder carcinoma. Used in combination with Adriamycin and Cyclophosphamide, remission rates could be increased to 80%. On the other hand toxicity is pronounced and the prolongation of survival times could not be proved until now as no results of controlled studies are available at this moment.
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