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Intravesical adjuvant therapy using mitomycin C.

M A Islam1, Z H Bhuiyan, I A Shameem

  • 1BSMMU, Dhaka.

Mymensingh Medical Journal : MMJ
|February 10, 2006
PubMed
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Intravesical Mitomycin C (MMC) is effective in preventing superficial bladder cancer recurrence. Both single immediate and delayed multi-dose MMC regimens showed similar efficacy, with high recurrence-free rates observed up to 36 months post-treatment.

Area of Science:

  • Urology
  • Oncology
  • Pharmacology

Background:

  • Superficial bladder cancer frequently recurs after transurethral resection (TUR).
  • Adjuvant intravesical chemotherapy is used to reduce recurrence rates.
  • Mitomycin C (MMC) is a commonly used agent for intravesical therapy.

Purpose of the Study:

  • To compare the efficacy of a single immediate intravesical Mitomycin C (MMC) dose versus a delayed multi-dose regimen in preventing superficial bladder cancer recurrence.
  • To evaluate the recurrence-free rates in patients with intermediate-risk superficial bladder transitional cell carcinoma (TCC) over a 36-month follow-up period.

Main Methods:

  • A randomized study involving 100 patients with intermediate-risk superficial bladder cancer.
  • Patients were assigned to receive either a single immediate intravesical MMC dose or a delayed multi-dose MMC regimen post-TURBT.

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  • Follow-up included regular cystoscopies for up to 36 months to monitor for tumor recurrence.

    • Main Results:

    • No recurrence was observed at 3, 6, and 9 months in either group.
    • Recurrence-free rates at 12 months were 94% for the immediate single-dose group and 96% for the delayed multi-dose group.
    • Recurrence-free rates at 36 months were 70% and 68% for the immediate and delayed groups, respectively, with no statistically significant difference (p>0.05) between the regimens.

    Conclusions:

    • A single immediate intravesical dose of Mitomycin C is as effective as a delayed multi-dose regimen in preventing recurrence of intermediate-risk superficial bladder transitional cell carcinoma.
    • Both treatment strategies demonstrate comparable long-term efficacy in reducing bladder cancer recurrence after TURBT.