Treatment of bladder carcinoma in situ with mitomycin C: long-term follow-up

Mitomycin C (MMC) was given intravesically to 14 patients with transitional-cell carcinoma in situ of the bladder (CIS) between 1985 and 1989. Of the 10 patients with complete response two presented progression during the follow-up: one of them in T2 at the 32nd month, and one had a relapse of CIS with diffusion to the prostatic urethra at the 34th month: both patients underwent cystectomy. One patient died of an unrelated cause. At the 48th month 5 out of 7 patients were free from neoplasm. Neoplastic recurrence occurred in 3 patients: one responded to a second endoscopic resection and instillation of MMC, two presented further recurrences. Two patients underwent cystectomy: one for neoplastic progression and one for involvement of the prostatic urethra. MMC seems to be effective in the treatment of CIS of the urinary bladder and the unresponsiveness to chemotherapy must be considered as an adverse prognostic factor for the progression of the neoplasm.