Exploring Patterns of Mitomycin C Use in Community Practice Urology

Area of Science:

• Urology
• Oncology
• Health Services Research

Background:

• Evidence supports mitomycin C use post-transurethral bladder tumor resection to reduce recurrence.
• Limited adoption of mitomycin C highlights a need to explore care patterns and barriers.
• Claims data analysis can reveal trends in mitomycin C utilization in community urology practice.

Purpose of the Study:

• To analyze contemporary trends in mitomycin C use in community urology.
• To identify patient, hospital, and surgical characteristics associated with mitomycin C administration.
• To assess the impact of age and comorbidities on mitomycin C use.

Main Methods:

• Analysis of a contemporary population-based cohort from the Premier Hospital database (2003-2015).
• Inclusion of patients undergoing transurethral bladder tumor resection.
• Multivariable logistic regression to evaluate associations with patient, hospital, and surgical factors, including age and comorbidities.

Main Results:

• Mitomycin C use increased from 3.3% (2003) to 5.5% (2013), then decreased to 4.5% (2015).
• Older patients (≥65 years) and those with higher Charlson comorbidity index showed varied associations with mitomycin C use.
• Higher annual surgeon volume was significantly associated with increased mitomycin C use (OR 1.68).

Conclusions:

• Mitomycin C remains underused in clinical practice despite a modest increase.
• Patients with greater comorbidities are less likely to receive mitomycin C.
• High-volume surgeons are more likely to administer mitomycin C, suggesting practice variations.