The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: A further report with 7 years of followup

D. A. Tolley, M. K.B. Parmar, K. M. Grigor, G. Lallemand, L. L. Beynon, S. J. Fellows, L. S. Freedman, R. R. Hall, T. B. Hargreave, K. Munson, D. W.W. Newling, B. Richards, M. R.G. Robinson, M. B. Rose, P. H. Smith, J. L. Williams, P. Whelan

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Abstract

Purpose: We determined the role, if any, of 1 and 5 instillations of intravesical mitomycin C in the treatment of newly diagnosed superficial bladder cancer. Materials and Methods: A multicenter randomized clinical trial was done involving 502 patients with newly diagnosed superficial bladder cancer. After complete transurethral resection patients were randomized into 1 of 3 treatment arms: no further treatment, 1 instillation of mitomycin C at resection and 1 instillation at resection and at 3-month intervals for 1 year (total 5 instillations). The dose of mitomycin C used was 40 mg./40 ml. water. End points were interval to first superficial recurrence, recurrence rate (defined as the number of positive cystoscopies per year) and progression-free interval rate (progression defined as the development of muscle invasive or metastatic disease, or death from bladder cancer). Results: After a median followup of 7 years 1 and 5 instillations of mitomycin C resulted in decreased recurrence rates and increased recurrence- free interval. The benefit of mitomycin C was observed in patients at low, medium and high risk for subsequent recurrence. There was suggestive but not conclusive evidence that 5 instillations of mitomycin C offered a slight advantage over 1 instillation. Conclusions: Our analysis confirms the positive benefit of mitomycin C to decrease the number of subsequent recurrences and increase the recurrence-free interval.

Original languageEnglish
Pages (from-to)1233-1238
Number of pages6
JournalJournal of Urology
Volume155
Issue number4
DOIs
StatePublished - Apr 1996
Externally publishedYes

Keywords

  • bladder neoplasms
  • drug therapy
  • mitomycin C
  • randomized controlled trials

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