The effect of intravesical single-dose Mitomycin C in recurrent superficial bladder cancer

Summary 

Objectives

This study was designed to evaluate the efficacy of the intravesical instillation of single-dose Mitomycin C post-ablation of purely recurrent tumours.

Patients and methods

Two patient groups with small-volume, low-grade (1 or 2), superficial (pTa) recurrent disease were studied. Sixty-seven patients at one institution received a single intravesical dose of Mitomycin C following tumour ablation using a Holmium YAG Laser. The other institution provided a control patient group of 68 patients treated with laser ablation alone. Patients were reviewed with regular flexible cystoscopies throughout the study period.

Results

The groups were matched for age and the number and grade of tumours. Recurrence rates were lower, yet not to statistical significance, in the group receiving Mitomycin C post-intervention (48% vs. 62% (p=0.14) at 12 months and 76% vs. 82% at 24 months (p=0.64)). The observed beneficial effect at 12 months appeared to depreciate by 24 months. There was no significant improvement in the recurrence-free interval for the Mitomycin C group (log rank test p=0.28).

Conclusions

This study has failed to demonstrate a beneficial trend for the use of single-dose of Mitomycin C after ablation of recurrent superficial bladder cancer. Further evaluation in the form of a prospective trial is indicated.

Abbreviations: TCC, transitional cell carcinoma, TUR, transurethral resection, TURBT, transurethral resection of bladder tumour, MMC, Mitomycin C

Keywords: Mitomycin C, Bladder cancer, Superficial, Recurrent