A comparison of mitomycin C and bacillus calmette-guerin for the prophylaaxis of high risk superficial bladder tumors / 대한비뇨기과학회지

ABSTRACT

We compared the prophylactic efficacy of intravesical mitomycin C with bacillus Calmette-Guerin instillation in the high risk superficial bladder tumor patients. Recurrent, grade III multiple (more than 3) or large(more than 3 cm) stage Ta or T1 tumors were included. Thirty patients were treated with 8 weekly instillation of 40mg of mitomycin C and 31 with 6 weekly instillation of 120mg or BCG. Thirty six patients were selected as a control Group. The mean follow-up period was 31.3 months in BCG, 27.7 months in mitomycin C and 23.2 months in control group. The overall one and two year recurrence rate was 52% and 62% in BCG, 70% and 80% in mitomycin C and 74% and 82% in control group. which was not statistically different(p>0.05) and the recurrence free pattern among three groups was not different statistically. But the mean time for recurrence and time for recurrence of 50 percent of the patients was 24.55 and 13 months in BCG group, which were longer than 14.2 and 5 months in mitomycin C and 12.72 and 7 months in control group. The tumor grade and number were lowered in the 20 recurrent tumors after BCG treatment with statistical significance. The overall 2 year recurrence rate was not significantly improved, BCG instillation resulted in improvement in grade, decrease in the number of the tumor and delay in time for recurrence in patients with high risk superficial bladder tumors. Although prophylactic efficacy of the BCG instillation is not complete, it would be provide reasonable benefit to the patients and is apparently superior to mitomycin C.