Intra vesicle instillation following trans uretheral resection of low grade and low stage bladder cancer proved its efficacy in reducing recurrence and progression of bladder cancer.
To compare the efficacy of a single session of mitomycine C versus six sessions mitomycine C following TURBT on recurrence and progression rates in patients with low risk non-muscle invasive bladder cancer.
PATIENTS AND METHODS:
A total of 50 patients with low risk non-invasive bladder cancer were included in a prospective randomized controlled trial. Inclusion criteria include all patients who had a 3cm or less, single, papillary tumor. The tumor was completely resected before were randomized patients into 2 arms; Group one; those who receiving one session mitomycin C instillation of 40 mg (usually within 6 hours) into the urinary bladder. And Group B; Receiving six sessions mitomycin C instillation into the urinary bladder, Median follow up was 24 months. The events studied where the recurrence free rate, the recurrence rate/ year, the number of new tumors developing/year, and progression.
At 24 months follow up, the recurrence free rate in a single session of mitomycin C instillation (group A) was (70.2%) while in six sessions mitomycin C instillation group was (84.7%) (Group B).
Recurrence rate was ; Group A VS Group B : (10% VS 4 %) and recurrence per year rate (5% VS 2%), were decreased in the six sessions mitomycin C instillation (Group B) compared to the single session mitomycin C instillation (Group A). The number of new tumors per year rate (18% VS 11%), were decreased in the six sessions mitomycin C instillation (Group B) compared to the one session mitomycin C instillation, (Group A). A shorter hospital stay, catheterization period, and low level of local symptoms were noted in one session mitomycin C instillation (Group A) compared to six sessions mitomycin C instillation, (Group B).
Single session mitomycin C given immediately after surgery or within 6 hours after resection may be as effective as six session protocol. This regimen may be cost effective and avoid prolonged hospitalization and catheterization with sex sessions regimen.