Immediate intravesical instillation of mitomycin C after transurethral resection of bladder tumor in patients with low-risk superficial transitional cell carcinoma of bladder.

Abstract

The aim of this study was to evaluate the effect of immediate intravesical instillation of mitomycin C after transurethral resection of bladder tumor (TURBT) in patients with low-risk superficial transitional cell carcinoma (TCC). A total of 43 patients with low-risk superficial bladder cancer were randomly assigned into two groups after the surgery; 22 patients in group 1 were treated by immediate instillation of mitomycin C after TURBT, and 21 patients in group 2 received placebo. The two groups were compared using urine cytology and cystoscopy during the 24 postoperative months. Recurrence within the first 3 months was reported in none of the patients in group 1 and 5 in group 2 (P = .02). Of these, 4 had recurrence of tumor in the primary site. At 12 and 24 months, there were 1 patient (4.5%) in group 1 and 8 (38.1%) in group 2 with recurrence (P = .007). We had no patients with multifocal recurrence in group 1, but 3 (14.2%) in group 2. Nine-month tumor-free survival rate was 95% in group 1. Three-, 6-, 9-, and 12-month tumor-free survival rates in group 2 were 76%, 71%, 66%, and 62%, respectively (P = .007). None of the patients in group 1 and 3 in group 2 (14.3%) experienced some degrees of tumor progression (P = .06). Immediate instillation of mitomycin C after TURBT seems to be effective in the recurrence reduction and increase of recurrence-free interval at least in short term.