Chystyakov R. Clinical efectiveness of hyperthermic intravesical chemoperfusion in the combined treatment of patients with high-risk non-muscle-invasive bladder cancer

Chystiakov R. S. Clinical efectiveness of hyperthermic intravesical chemoperfusion in the combined treatment of patients with high-risk non-muscle-invasive bladder cancer. — Qualifying scientifc work as a manuscript. A thesis for Doctor of Philosophy in the feld of knowledge 22 — "Health care" by specialty 222 — "Medicine". — Odesa National Medical University MH of Ukraine, Odesa, 2023. The thesis is devoted to the current problem of oncological urology — improvement of treatment of patients with high-risk non-muscleinvasive bladder cancer (NMIBC) by using hyperthermic intravesical chemoperfusion in the adjuvant mode. Purpose: The study purposed to increase the effectiveness of treatment of patients with high-risk non-muscle-invasive bladder cancer by using hyperthermic intravesical chemoperfusion in the adjuvant mode after transurethral bladder resection. Methods: From March 2018 to January 2021, 53 patients with high-risk NMIBC underwent a HIVEC adjuvant regimen at the University Clinic of Odessa National Medical University (UC ONMedU). The results were compared with a group of patients who received adjuvant intravesical BCG therapy from 2015 to 2019. Results: The incidence of the disease recurrence (42.6% versus 22.6%) and progression (20.4% versus 7.5%) were significantly different between the BCG and HIVEC, respectively. The mean time to recurrence in patients who received HIVEC MMC was significantly higher than in patients of the BCG group: 31.5 months (95% CI: 29.1-34.0) versus 26.0 months (95% CI: 22.7-29.3), respectively (p = 0.034). Cox regression analysis showed hazard ratio for HIVEC vs BCG for the RFS at 36 months to be 0.48 (95% CI: 0.24-0.96; p=0.04). Conclusion: Hyperthermic intravesical chemotherapy with the addition of DMSO is a safe treatment option for patients with high-risk noninvasive bladder cancer with efficacy comparable to BCG therapy.