Effectiveness of immediate Mitomycin C instillation in patients with low risk non-muscle invasive bladder cancer

ABSTRACT

We determined if immediate instillation chemotherapy after transurethral resection [TUR] decrease the risk of recurrence and/or progression in patient with stage Ta T1 bladder cancer. This study has been designed to analyze the impact of a single immediate mitomycin C instillation after transurethral resection of bladder cancer on recurrence and progression rates in patients with low risk superficial bladder cancer. A total of 50 patients with low risk superficial bladder cancer were included in a prospective randomized controlled trial. All patients had a 3 cm. or less single, papillary bladder tumor. The tumor was completely resected before patients were randomized into 2 arms of no further treatment [control group] and a single immediate instillation [usually within 6 hours] of 40 mg. mitomycin C [mitomycin c group]. Median follow up was 24 months .The events studied were the recurrence free rate, the recurrence rate/year, and the number of new tumors developing /year. At 24-month follow-up the recurrence-free rate was significantly increased [84.7% VS 54.2%]. Recurrence [15.3% VS 45.8%], and recurrence per year rate [7% VS 20%] and tumor per year rate [11% VS 33%] were significantly decreased in the mitomycin C compared to the control group. This study confirms the positive effect of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer. Thus, this approach is an alternative to observation. This study also suggests cell implantation as a mechanism of early recurrence can be controlled with a single immediate mitomycin C instillation