[Periodic prophylactic bladder instillation (PPI) of mitomycin C]

Area of Science:

• Urology
• Oncology
• Pharmacology

Background:

• Recurrent bladder tumors pose a significant challenge after surgical treatment.
• Evaluating intravesical chemotherapy for recurrence prevention is crucial.

Purpose of the Study:

• To assess the efficacy of preoperative bladder instillation (POI) and periodic prophylactic bladder instillation (PPI) in preventing recurrent bladder tumors post-surgery.

Main Methods:

• A study involving 191 patients with pTa or pT1 bladder tumors undergoing TURbt or partial cystectomy.
• Patients were divided into four groups receiving different combinations of POI and PPI.
• POI involved 20 applications of anticancer drugs pre-surgery; PPI used Mitomycin C and 5-FU post-surgery.

Main Results:

• Five-year non-recurrence rates were significantly higher in groups receiving PPI (82.4% and 81.0%) compared to those without PPI (32.0% and 35.1%).
• POI demonstrated a limited effect, primarily within the first two years post-surgery.
• No carcinogenic effects on bladder epithelium were noted with topical Mitomycin C use.

Conclusions:

• Periodic prophylactic bladder instillation (PPI) is effective in preventing bladder tumor recurrence.
• Preoperative bladder instillation (POI) has a minimal impact on long-term recurrence rates.
• Mitomycin C is a safe agent for topical bladder instillation in this context.