The Effect of Adding an Initial Dose of Mitomycin C into the Ve-sicular Delayed Six-Week Treatment in Patients with Superficial Bladder Cancer

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Resident, Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Bladder tumors have a high incidence and despite being superficial in a majority of cases, the amount their relapse after transurethral resection of bladder tumour (TURBT) surgery is high. Treatment after TURBT with in vesicular methods is a way to overcome relapse. The purpose of this study was to determine the effect of implementation of adding a dose of mitomycin into the vesicular delayed six-week treatment of patients with superficial bladder cancer on the rate and degree of tumor recurrence in patients referred to Alzahra and Noor hospitals in Isfahan.Methods: In this prospective study, patients with superficial bladder tumors were selected and randomly devided in one of case or control groups. The sample size for each group was 18 patients. Patients in case group received a dose of mitomycin C after TURBT; then, both groups underwent delayed six-week treatment. Results in terms of numbers, time, grade, and stage of recurrence were analyzed using chi-square, Mann-Whitney, and Independent-t tests.Finding: 33.3% of patients in case group and 66.7% of controls experienced relaps (P = 0.04). The grade of relapsed tumor was significantly difference between the two groups (P = 0.001). The mean frequency of relapse was 0.5 ± 0.78 in case group and 1.1 ± 1.0 in control group (P = 0.04). The stage of relapsed tumors in the control group with the larger proportion was of type T1 (P = 0.006) but the time of relapse was not significantly difference between groups (P = 0.09). The relapse time was 12.5 ± 14.1 months in case group and 6.7 ± 3.7 months in control group.Conclusion: Considering the reduced number, stage, and grade of relapse in case group, the positive effect of immediately mitomycin after TURBT was proved. Studies with more patients and further follow-up period are necessary to review late relapses.

Keywords

References

  1. Edward M, Messing MD. Urothelial Tumors of the Bladde. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, Editors. Campbell-Walsh Urology Online. Philadelphia: Elsevier Health Sciences; 2006.
  2. Di Stasi SM, Giannantoni A, Stephen RL, Capelli G, Navarra P, Massoud R, et al. Intravesical electromotive mitomycin C versus passive transport mitomycin C for high risk superficial bladder cancer: a prospective randomized study. J Urol 2003; 170(3): 777-82.
  3. Gasion JP, Cruz JF. Improving efficacy of in-travesical chemotherapy. Eur Urol 2006; 50(2): 225-34.
  4. Hausladen DA, Wheeler MA, Altieri DC, Col-berg JW, Weiss RM. Effect of intravesical treatment of transitional cell carcinoma with bacillus Calmette-Guerin and mitomycin C on urinary survivin levels and outcome. J Urol 2003; 170(1): 230-4.
  5. Whelan P. Treatment of superficial Bladder cancer: ADiscussion on Intravesical Immunotherapy and intravesical chemotherapy. European Urology Supplements 2004; 3: 70-2.
  6. Michielsen D, Amy JJ, Coomans D, Storme G, Wyndaele JJ. Mitomycin C and epirubicin: functional bladder damage in rats after repeat intravesical instillations. J Urol 2005; 173(6): 2166-70.
  7. Kondas J, Kiss L, Hatar A, Kiss A, Lukacs T, Szeldeli P, et al. The effect of intravesical mitomycin C on the recurrence of superficial (Ta-T1) bladder cancer. A Hungarian Multicenter Study. Int Urol Nephrol 1999; 31(4): 451-6.
  8. Solsona E, Iborra I, Ricos JV, Monros JL, Casanova J, Dumont R. Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 1999; 161(4): 1120-3.
  9. Serretta V, Pavone C, Ingargiola GB, Daricello G, Allegro R, Pavone-Macaluso M. TUR and adjuvant intravesical chemotherapy in T1G3 bladder tumors: recurrence, progression and survival in 137 selected patients followed up to 20 years. Eur Urol 2004; 45(6): 730-5.
  10. El Ghobashy S, El Leithy TR, Roshdy MM, El Ganzoury HM. Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term follow-up. J Egypt Natl Canc Inst 2007; 19(2): 121-6.
  11. Isbarn H, Budaus L, Pichlmeier U, Conrad S, Huland H, Friedrich MG. Comparison of the effectiveness between long-term instillation of mitomycin C and short-term prophylaxis with MMC or bacille Calmette-Guerin. Study of pa-tients with non-muscle-invasive urothelial cancer of the urinary bladder. Urologe A 2008; 47(5): 608-15.
Journal of Isfahan Medical School
Volume 28, Issue 121 - Serial Number 121
November and December 2011
Pages 1648-1654

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History

  • Receive Date: 20 March 2011
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

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