{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T08:17:02Z","timestamp":1786436222740,"version":"build-2736575974"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,5,23]],"date-time":"2015-05-23T00:00:00Z","timestamp":1432339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To evaluate oncological outcomes after combination intravesical therapy with gemcitabine (\n                      <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>\n                      ) and mitomycin C (\n                      <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>\n                      ) in the setting of recurrent non\u2010muscle\u2010invasive bladder cancer (\n                      <jats:styled-content style=\"fixed-case\">NMIBC<\/jats:styled-content>\n                      ) after failure of previous intravesical therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively identified patients with recurrent\n                      <jats:styled-content style=\"fixed-case\">NMIBC<\/jats:styled-content>\n                      after previous intravesical therapy, who refused or were not candidates for cystectomy, between 2005 and 2011.\n                      <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>\n                      were sequentially instilled weekly for 6\u20138\u00a0weeks. Data were collected regarding patient demographics, bladder cancer history, and number and type of intravesical therapies before\n                      <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>\n                      . Outcomes evaluated included time to recurrence and\/or progression after\n                      <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>\n                      . Recurrence\u2010free outcomes were estimated using the Kaplan\u2013Meier method, and Cox proportional hazards regression models were used to test the association of clinicopathological features with outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all, 27 patients were identified, 23 with high\u2010risk disease (high\u2010grade or carcinoma\n                      <jats:italic>in\u00a0situ<\/jats:italic>\n                      ) and four with intermediate\u2010risk disease (multifocal or recurrent low\u2010grade). All patients received prior intravesical therapy, and 17 patients (63%) received multiple courses. Twenty\u2010four patients were treated with\n                      <jats:styled-content style=\"fixed-case\">BCG<\/jats:styled-content>\n                      . The median (range) disease\u2010free survival of all patients was 15.2 (1.7\u201339.3) months. Seventeen patients (63%) developed recurrent bladder cancer, a median of 15.2\u00a0months after therapy. One patient progressed to muscle\u2010invasive disease 5\u00a0months after treatment, and one developed metastatic disease 22\u00a0months after treatment. Three patients went on to cystectomy. Ten patients (37%) had no evidence of disease at last follow\u2010up, with a median follow\u2010up of 22.1\u00a0months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The combination of intravesical\n                      <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">MMC<\/jats:styled-content>\n                      could offer durable recurrence\u2010free survival to some patients with recurrent\n                      <jats:styled-content style=\"fixed-case\">NMIBC<\/jats:styled-content>\n                      who are not candidates for, or refuse, cystectomy.\n                    <\/jats:p>\n                  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