Efficacy Of Mitomycin Research Articles

Mitomycin C vs. Bacillus Calmette–Guerin for treatment of intermediate-risk nonmuscle invasive bladder cancer patients—A comparative analysis from a single center

BackgroundInduction followed by 1 year maintenance instillation of intravesical Bacillus Calmette–Guerin (BCG) is the standard treatment for intermediate-risk (IR) nonmuscle invasive bladder cancer (NMIBC) patients. Few data exist on the efficacy of Mitomycin C (MMC) instillation in this setting. MethodsWe retrospectively analyzed 226 IR-NMIBC patients classified by the International Bladder Cancer Group (IBCG) and 250 IR-NMIBC intravescical treatment-naïve patients classified by the European Association of Urology (EAU). All patients received either a full induction course of BCG or 40 mg/40 ml MMC from 2012 to 2022. Optimal treatment was defined as 1-year maintenance for BCG and 11 monthly maintenance instillations for MMC. Kaplan–Meier analysis estimated recurrence-free survival (RFS) before and after inverse probability of treatment-weighting (IPTW) and progression-free survival (PFS). Multivariable Cox regression was used to evaluate difference in recurrence after adjustment for clinically relevant variables before and after IPTW. ResultsOptimal BCG and MMC courses were administered to 21% of IR-IBCG and 23% of IR-EAU patients. At 4-years, patients treated with optimal MMC and BCG treatment had similar RFS and PFS in both EAU and IBCG groups. Patients receiving nonoptimal BCG compared to optimal MMC exhibited lower 4-year RFS after IPTW (82% vs. 68% in EAU and 82% vs. 65% in IBCG). At 4-year optimal MMC had greater PFS non optimal BCG. Optimal MMC treatment predicted recurrence in EAU (adjusted and weighted HR 0.33, 95% CI, 0.11-0.98) and IBCG (adjusted and weighted HR 0.29, 95% CI, 0.08-0.97) groups compared to nonoptimal BCG. ConclusionsOptimal 40 mg/40 ml MMC treatment was as effective as optimal BCG in IR-IBCG and IR-EAU NMIBC patients, reducing both recurrence and progression compared to nonoptimal BCG. MMC could be a valid first line alternative to BCG for both IR-EAU and IR-IBCG intravescical treatment-naïve patients, during BCG shortages.

Efficacy of Mitomycin C in Prevention of Adhesions Formation after Functional Endoscopic Sinus Surgery

Efficacy of Mitomycin C in Prevention of Adhesions Formation after Functional Endoscopic Sinus Surgery

Efficacy of mitomycin C in modified transcanalicular diode laser dacryocystorhinostomy

Efficacy of mitomycin C in modified transcanalicular diode laser dacryocystorhinostomy

Efficacy of mitomycin C in adjunct with intralesional steroids in the management of oral submucous fibrosis: A case report

A case of oral submucous fibrosis in a 45-year-old woman discusses its etiopathogenesis, clinical features of the condition and highlights the strong association of areca nut chewing as the potential factor in the etiology of this condition. Cessation of the areca nut chewing habit and submucosal administration of mitomycin and triamcinolone acetonide along with active physiotherapy exercises showed marked improvement of the condition.

Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study.

Purpose:To determine the safety and efficacy of mitomycin C (MMC) injection versus sponge during trabeculectomy.Methods:It is a prospective analysis of patients who underwent trabeculectomy with MMC and followed up for 1 year, divided into two groups, namely, group 1- injection (n = 21), group 2- sponge (n = 21). The same concentration of MMC was used for both groups. Inclusion criteria were trabeculectomies with MMC for intraocular pressure (IOP) control in eyes with glaucoma (primary + secondary) with a follow-up of 1 year.Results:Mean preoperative IOP in group 1 was 29.00 ± 11.92 mmHg and group 2 was 25.87 ± 11.09 mmHg, which reduced to 12.19 ± 4.03 and 15.56 ± 10.72 mmHg at final visit with P value of 0.0002 and 0.001, respectively. Mean preoperative number of antiglaucoma medications was 2.4 ± 0.87 in group 1 and 2.3 ± 0.96 in group 2, which reduced to 0.38 ± 0.5 and 0.91 ± 0.85 with P value of 0.001 and 0.0003, respectively. The complete success rate was 52.4% in the injection group and 26.1% in the sponge group at end of 1 year. Overall, success rate (complete + qualified) was 90.5% and 87% in group 1 and group 2 at final visit. All major complications were encountered in sponge group. 1 (11.1%) patient developed choroidal detachment and one had malignant glaucoma which got resolved by medical management. 33.3% cases had encapsulated bleb which received bleb needling. 44.4% cases underwent Argon laser suture lysis postoperatively.Conclusion:The MMC injection may be as safe and as effective as conventional sponge application with comparable estimated complete treatment success.

Efficacy of Mitomycin c in Reducing the Recurrence of Urethral Stricture after Visual Internal Urethrotomy (VIU)

Urethral stricture remains one of the oldest known urologic diseases and also still a common problem with high morbidity. Recurrence rate of VIU is high in different studies ranging from 20% to 60%, the aim of this study was to assess the efficacy of MMC in reducing the recurrence of urethral stricture after VIU. Our consider incorporated 30 patients torment from < 2 cm urethral stricture, starting with might 2018 should november 2019. These patients were randomized under two aggregations; gathering An (study group) incorporated 15 patients who were subjected with intralesional MMC then afterward VIU, What's more one assembly b (control group) incorporated 15 patients who were subjected to VIU best. Utilizing An Cold-knife those urethrotomy might have been performed under immediate dream What's more incisions were aggravated during 12-, 5-, What's more 7 O’clock positions taken after Toward intralesional infusion from claiming MMC. Every one patients were took after dependent upon to 6 months and the stricture repeat rate might have been compared the middle of those two aggregation. Of the aggregate 30 patients, 4 patients clinched alongside gathering a and 3 tolerant On one assembly b were lost should catch up in the initial 2 months Furthermore Subsequently were dropped from the ponder. Those test might have been consequently decreased will 23 patients who were separated under two aggregations. Bunch An (study group) comprised 11 patients who were subjected should intralesional mitomycin c's after VIU. Aggregation b (control group) comprised 12 patients who underwent VIU main. There might have been statistically critical Contrast the middle of 2 bunches in regards will stricture repeat ; 2 patients On one assembly a (18. 2%) Furthermore 7 patients On bunch b (58. 3%) required repeat (p=0. 02). Various intralesional MMC injections Emulating VIU need An possibility with markedly decrease those repeat about urethral stricture.

Intra-arterial Mitomycin C infusion in a large cohort of advanced liver metastatic breast cancer patients: safety, efficacy and factors influencing survival.

The aim of this study was to determine the safety and efficacy of Mitomycin C (MMC) infusion in a large cohort of advanced liver metastatic breast cancer patients (LMBC) and to determine factors influencing overall survival (OS). We retrospectively analysed LMBC patients, treated with MMC infusion between 2000 and 2017. Hepatic response was measured with baseline CT scans and first available CT scan after MMC infusion by RECIST 1.1 criteria. Adverse events were registered by the CTCAE version 5.0. OS and hepatic progression free survival (hPFS) were evaluated using Kaplan-Meier estimates. After univariable analysis, a stepwise forward multivariable (MV) prediction analysis was developed to select independent pre-treatment factors associated with OS. We included 176 patients with a total of 599 MMC infusions, mostly heavily pre-treated patients with a median time from diagnosis of MBC to MMC infusion of 36.9months. RECIST evaluation of liver lesions (n = 132) showed a partial response rate of 15%, stable disease of 43% and progressive disease in 17%. Adverse events grade 3 and 4 were reported in 17.5%. Median PFS was 5.5months and median OS was 7.8months. Significant independent baseline predictors of worse OS included number of prior systemic chemotherapy lines, prior liver ablation, higher liver tumour burden and elevated levels of bilirubin and ALT. MMC infusion is safe and effective in advanced LMBC patients. An increased number of prior therapies, a higher liver tumour burden and elevated levels of bilirubin and ALT were associated with a worse OS.

Endoscopic Injection of Mitomycin C for the Treatment of Pharyngoesophageal Stenosis Refractory to Endoscopic Treatment with Dilatation in Patients Treated for Head and Neck Cancer.

Background Management of pharyngoesophageal stenosis (PES) in patients after head and neck cancer (HNC) treatment remains a challenge. It is not uncommon that PES is refractory to dilation sessions. This study aimed at evaluating the efficacy of Mitomycin C (MMC) endoscopic injection for the treatment of refractory pharyngoesophageal stenosis. Patients and methods This is a prospective study in patients with dysphagia following head and neck cancer treatment, without evidence suggestive of tumor recurrence, and refractory to endoscopic treatment. These patients were submitted to endoscopic dilation of the stenotic segment with thermoplastic bougies, followed by injection of MMC. We repeated the endoscopic sessions every three weeks. Results From January 2015 to May 2015, we treated 13 patients with PES. Three patients were initially enrolled in the study for refractory stricture. We observed adverse events in all of them, with intense neck pain and ulcer development, justifying the interruption of the trial. Conclusion The repeated injection in the short interval of MMC in refractory PES is not recommended, because it resulted in serious adverse events.

Comparison of triamcinolone and mitomycin C nasal pack in functional endoscopic sinus surgery: a randomized, clinical trial

Aims and ObjectivesSynechia formation in a postoperative nasal cavity is a major factor for suboptimal clinical outcome in functional endoscopic sinus surgery (FESS). Nasal packs medicated with steroids like triamcinolone and topical agents like mitomycin C have been shown to reduce the formation of synechiae in postoperative patients. This study attempts to compare the efficacy of mitomycin C and triamcinoloneimpregnated nasal pack in the prevention of crusting and synechiae formation in patients undergoing FESS.MethodsNinety-eight consenting patients with chronic rhinosinusitis were randomized into two groups of 49 each to receive either triamcinolone-impregnated or mitomycin C-impregnated nasal pack after FESS. Blinded, postoperative endoscopic examination was done at the first and third week and at first and third month and scoring was done according to the Lund Kennedy scoring system. The primary variable for assessing the outcome was synechiae formation in the postoperative period, while reduction of crusting, discharge, mucosal edema, polypoidal mucosal changes, and maintenance of ostial patency were secondary variables.ResultsSignificant reduction in synechiae formation and crusting at 3 months duration was found in the group receiving triamcinolone nasal pack as compared with mitomycin C nasal pack. Mitomycin C was found to significantly reduce crusting in the first postoperative week. Positive trends in reduction of discharge, mucosal edema, polypoidal changes, and in maintenance of patency of ostia were observed in both the groups, but there was no significant difference between the two groups.ConclusionThese results suggest that triamcinolone has a long-term effect in the reduction of synechia formation and crusting in post-FESS patients as compared with mitomycin C, though similar effects were seen in both groups in the immediate postoperative period.

Опыт применения Митомицина С после баллонной дакриопластики

Опыт применения Митомицина С после баллонной дакриопластики

Efficacy of Mitomycin C for the treatment of serious reactions after dacryocystorhinostomy

Objective To evaluate the efficacy of Mitomycin C for the treatment of serious reactions after dacryocystorhinostomy. Methods The data of 120 eyes of 120 patients with serious reactions after dacryocystorhinostomy were reviewed by endoscopy. They were randomly divided into two groups. In the control group, 60 paitent’s lacrimal duct were flushed with normal saline. In the test group, 60 paitent were appressed in anastomotic stoma with 0.2g/L Mitomycin C and last for 5 minutes before lacrimal ducts were flushed. Average follow-up time was (14.0±2.6) months. The degree of lacrimal duct patency and the complications were observed. Results There were 21 cases with serious obstruction and 26 cases with mild or moderate obstructive. And inflammation subsided for (3.5±0.6) months in control group. Serious obstruction occurred in 3 cases and mild or moderate obstructive in 22 cases. And inflammation subsided for (2.8±0.5) months in test group. The difference in the time of inflammation subsided was significant. Conclusion It is safe and effective for paitents with serious reactions using Mitomycin C after dacryocystorhinostomy. It can significantly inhibite the proliferation of adhesions occurrence, reduce inflammatory reactions, and rebuild a significant effect on the promotion of the lacrimal function. Key words: Dacryocystorhinostomy; Postoperaitive reaction; Mitomycin C; Efficacy

Simultaneous Use of Amniotic Membrane and Mitomycin C in Trabeculectomy for Primary Glaucoma: A Pilot Study

Purpose: Role of amniotic membrane transplantation as an additional modulator in primary Mitomycin C augmented trabeculectomy. Design: Randomised prospective interventional study. Methods: 40 eyes of 39 adult patients with uncontrolled primary glaucoma were randomly divided into 2 equal groups. Control group underwent trabeculectomy augmented with Mitomycin C while the study group underwent additional amniotic membrane transplantation. Patients were followed up for 12 months and outcomes measured were Intraocular Pressure, need for additional intervention and bleb morphology. Results: Complete success (defined as intraocular pressure <16 mmHg on no medication) could be achieved in 85% eyes in study group while it was 60% in control group (p=0.04). Intraocular pressure reduced by 71.1% in study group from 41.9 ± 10.6 mmHg to 12.1±2.7 mm Hg and from 40.5 ± 8.5 mmHg to 12.8 ± 4.5 mmHg in control group, a decline of 68.29%. Blebs in amniotic membrane transplantation group showed better bleb morphology in terms of significantly better extent (E3) on day 1 (p=0.03) and better height (H2 and H3) (p=0.04), according to Indiana Bleb Appearance Grading Scale, at all follow up visits along with normal vascularity. The study group required significantly lesser (p=0.03) bleb needlings as compared to control group. Conclusion: Amnion enhanced the efficacy of Mitomycin C modulated trabeculectomy in terms of eyes with complete success and lesser interventions like bleb needling. This reiterates the role of amnion as a safe and effective bleb modulator. A diffusely elevated bleb with healthier conjunctiva can go a long way in predicting better health and longevity of the bleb.

E03* - Efficacy of Mitomycin C plus a Fluoropyrimidine in pre-treated patients with metastatic colo-rectal cancer eligible to Regorafenib. Results of a retrospective study

E03* - Efficacy of Mitomycin C plus a Fluoropyrimidine in pre-treated patients with metastatic colo-rectal cancer eligible to Regorafenib. Results of a retrospective study

Efficacy of mitomycin C plus a fluoropyrimidine in pretreated patients with metastatic colorectal cancer eligible to regorafenib: Results of a retrospective study.

e14661 Background: Mitomycin C (MMC) and a Fluoropyrimidines (FPDs) represent a viable treatment option for patients (pts) that would currently be eligible for Regorafenib (RGR) after the publicati...

Efficacy of Mitomycin C on healing in endoscopic sinus surgery: A systematic review

Efficacy of Mitomycin C on healing in endoscopic sinus surgery: A systematic review

The efficacy of mitomycin and stenting in choanal atresia repair: A 20 year experience

ObjectiveTo determine the efficacy of topical mitomycin and stenting in patients that have undergone endoscopic repair of choanal atresia. MethodsRetrospective review of 37 endoscopic operations on pediatric patients for choanal atresia. ResultsTwenty-six sides were operated on in 17 patients; 37 total operations were performed. All 17 patients were repaired endoscopically with 1 patient requiring transpalatal revision surgery. Eight patients (47%) had a unilateral atresia and 9 (53%) were bilateral. Eleven total sides (42%) were treated initially with mitomycin. Eighteen percent of those sides required post-operative dilation vs. 40% of the sides not treated with mitomycin (p=0.39) and no patient in the mitomycin group required revision surgery compared to 20% of patients not treated with mitomycin (p=0.24). Significantly fewer sides in the mitomycin group (9%) developed granulation vs. those treated without (53%) (p=0.03). The average number of procedures performed (1.18 vs. 2.53; p=0.002) was significantly fewer in those patients treated with mitomycin vs. not. A greater amount of sides in the stent group developed granulation tissue (50% vs.0%; p=0.023). The average number of procedures performed was significantly greater in those patients treated with a stent (2.33 vs. 1.12; p=0.008). The average time spent in the hospital was significantly shorter (7.09 vs. 2.33 days; p=0.02) in those patients treated without stenting. ConclusionTopical mitomycin is efficacious as an adjuvant therapy as it was associated with the formation of less granulation tissue, a lower rate of restenosis and fewer surgeries. Stenting was associated with significantly more procedures, greater formation of granulation tissue and longer overall hospital stays. However, consideration should be given toward stent placement in all neonates for the prevention of post-operative airway obstruction.Level of evidence: 2c.

Efficacy of Mitomycin C for postoperative endoscopic sinus surgery: a systematic review and meta‐analysis

Mitomycin C has recently been used to prevent nasal synechiae and sinus ostium stenosis after endoscopic sinus surgery. To compare nasal synechiae rate between topical Mitomycin C and saline or no treatment. Systematic review and meta-analysis. MEDLINE, SCOPUS, and Cochrane Register of Controlled Trials databases were used to identify studies up to January 2013. Data were independently extracted by two reviewers (PN and KT). Studies which compared topical Mitomycin C with control where the outcomes of interest were nasal synechiae or sinus ostium stenosis were included. Baseline study characteristics, quality of study, numbers of patients between treatment and control groups, outcomes, and adverse events were extracted. A multivariate meta-analysis was separately applied for each outcome (nasal synechiae and maxillary sinus ostium stenosis). Among 11 included studies, most studies used Mitomycin C dose of 0.4-0.5 mg/mL 1-5 mL in the middle meatus for 5 min duration. Eight studies reported synechiae with 281 and 281 nasal cavities received Mitomycin C and saline, respectively. For outcome of nasal synechiae, a multivariate meta-analysis suggested that Mitomycin C was associated with a 66% (RR = 0.34, 95% CI: 0.18-0.65) lower risk of nasal synechiae with moderate heterogeneity (I(2) = 43%, 95% CI: 0-77%). Subgroup analyses by age and history of revision could reduce the degree of heterogeneity. Mitomycin C benefits were found in subgroups of age ≤ 40 years (RR = 0.27, 95% CI: 0.05-1.50) and patients without any history of revision (RR = 0.19, 95% CI: 0.06-0.58). Five studies with 134 and 140 nasal cavities for Mitomycin C and saline were included in pooling of maxillary sinus ostium stenosis. Mitomycin C was associated with 74% (RR = 0.26, 95% CI: 0.12-0.54) lower risk of maxillary sinus ostium stenosis when compared with saline with low heterogeneity (I(2) = 5%, 95% CI: 0-85%). There was no evidence of publication bias for both poolings. Applying Mitomycin C topically after endoscopic sinus surgery could reduce the risk of nasal synechiae and maxillary sinus ostium stenosis in short term by 66% and 74%, respectively. The treatment effects may be more beneficial in patients aged 40 years or younger or in patients without history of revision. However, our results were based on pooling trials with questionable methodological quality. Further trials with good research methodology and long-term follow-up should be conducted to confirm our results.

Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.

BackgroundA number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.Methods and FindingsA comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (−1.04, 24.29), P = 0.072].ConclusionIntraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR.Trial RegistrationClinicalTrials.gov NCT01772277

Mitomycin C: An effective adjuvant in the management of ocular surface squamous neoplasia

Background: Ocular surface squamous neoplasia (OSSN) forms a spectrum of dysplasia from conjunctival-corneal intraepithelial neoplasia to an invasive squamous cell carcinoma (SCC). Management of OSSN is surgical excision; however, with a high reported recurrence rates (33 to 56%). Hence, Mitomycin C, a tumor-targeted deoxyribonucleic acid (DNA) synthesis inhibitor is considered as an adjuvant following excision of primary OSSN. Aim: To report the cure and recurrence rate with excision of primary OSSN with Mitomycin C as an adjunctive ina single ocular center over 1 year period. Materials and Methods: Twelve eyes of 12 patients with histologically proven primary were included in the study between 1 st Jan 2009 and 31 st Dec. 2009. Protocol for the management comprised of surgical excision of the lesion with a 3 mm of healthy rim with cryotherapy followed by topical Mitomycin C 0.04% four times a day to all postoperative patients in 3-4 cycles of alternate on and off weekly courses. At each visit, looked for recurrence of tumor and corneal alterations like keratitis or erosions. Efficacy of Mitomycin C as an adjuvant therapy was measured in terms of clinical cure and recurrence of the tumor. Results: Average age 45.25 years with 42% below 40 years with 83% male preponderance. With a follow up period of 44.5 months, 91.7% success rate found despite late stage presentation in our study. Conclusion: Hence, we conclude that, Mitomycin C treatment following surgical excision decreases the recurrencerate of primary ocular surface neoplasia and should be considered as adjunctive therapy in primary treatment.

The application of Mitomycin C combined with adjustable suture in trabeculectomy

Objective To discuss the efficacy of Mitomycin C combined with adjustable suture in trabeculectomy.Methods Seventy five cases (120 eyes) with primary glaucoma had received trabeculectomy,combined with Mitomycin C and adjustable suture.The visual acuity,filtrating blebs,depth of anterior chamber and the intraocular pressure were observed after the operation,with 4 - 20 months of follow-up.Results The visual acuity improved in 101 eyes.There were type Ⅰ filtering blebs in 23 eyes,type Ⅱ in 93eyes,and type Ⅲ in 4 eyes.Degree Ⅱ of shallow anterior chamber occurred in 25 eyes,and degree Ⅱ in 9eyes.The intraocular pressure was 0 ～ 10 mmHg in 6 eyes,11 ～ 20 mmHg in 110 eyes,21 ～ 30 mmHg in 4eyes.Conclusion In trabeculectomy,the application of Mitomycin C combined with adjustable suture could reduce the postoperative complications. Key words: Glaucoma, primary; Trabeculectomy; Mitomycin C; Suture, adjustable