SINGLE INSTILLATION OF MITOMYCIN C REDUCES 1ST YEAR RECURRENCE FOLLOWING TRANSURETHRAL RESECTION OF NON-MUSCLE INVASIVE BLADDER CANCER
Abstract
Objective: To study the impact of single instillation of 40 mg Mitomycin C (MMC-40) within firsthour of transurethral resection (TUR), on first year recurrence of non-muscle invasive bladdercancer. Methods: In this study of two groups of patients with similar demographics and tumourprofile were compared to assess first year tumour recurrence pattern. Group A received MMC-40within 30 minutes of TUR. Group B patients only had TUR of bladder tumour. Patients’ charts werereviewed for demographic profile, preoperative diagnosis and imaging used, cytological work up,tumour profile both during cystoscopy and imaging used, patients records were also reviewed for allsubsequent check cystoscopies for recurrence. Any adjuvant treatments like intravesicalchemo/immunotherapy etc. were also noted. The results were analysed using a commerciallyavailable statistical package, SPSS™. The level of significance was 0.05. Results: There were 29and 46 patients in group A and B respectively. The demographic profile in terms of age, genderdistribution, tumour characteristics (size, site, multiplicity) and pathological evaluation including,tumour grade and presence of carcinoma in situ were similar (p<0.4 and p<0.5) respectively. Thefirst year recurrence rate in group A was 15% whereas it was 37.4% in group B (p<0.04).Conclusions: The first year recurrence rate is significantly decreased if MMC-40 is instilledfollowing TUR. MMC-40 is safe and cost effective. Most low grade, low volume tumours would notrequire any further treatment if MMC-40 is given immediately following TUR.Key words: non-muscle invasive bladder cancer, single instillation of chemotherapeutic agent,recurrenceReferences
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