Recurrences and Progression of Superficial Bladder Cancer following Long-Term Intravesical Prophylactic Therapy with Mitomycin C: 48-Month Follow-Up

Abstract

A total of 208 patients with superficial transitional-cell carcinoma of the bladder (STCC) after transurethral resection were treated with 30 mg intravesical instillations of mitomycin C (MMC) weekly for 8 weeks, followed by monthly maintenance doses for 12 months. All patients were controlled with a urinary cytological examination every 2 months and with cystoscopy every 3 months. Mean follow-up was 47.8 and 49.3 months in the prophylaxis and control groups, respectively. The incidence of tumor recurrences at the 12th and 48th months was 29 and 44%, respectively, in the MMC group and 45 and 58%, respectively, in the control group. Progression evaluated by grade and stage was significantly higher in the control group. These data indicate that MMC appears to be effective in the prophylaxis of STCC, but the possibility of long-term relapse suggests maintenance of a longer therapy.

Bacillus Calmette?Guerin-refractory superficial bladder cancers: focus on pretreatment episodes

“…Similar to open surgery, injury brings about local and general suppression of the immune system. 25,26 The literature contains many reports of prophylactic effects of anticancer drugs on superficial bladder cancers, [27][28][29] but long-term follow-up suggests that efficacy does not persist for many years. 9 The prophylactic effects of BCG, on the other hand, are reported to extend over very long periods, [19][20][21] including, in one report, a follow-up of greater than 10 years.…”

Intravesical Instillation of Mitomycin-C in 242 Patients with Superficial Bladder Cancer at High Risk of Recurrence: Long-Term Results

“…Median time to first recurrence in patients treated with MMC ranges from 15 to 36 months [23,24,28]. The recurrence rate (number of recurrences per 100 patients/month) has been reported to be 0.46-8.7 in patients treated with MMC [9,23,24,26,28,29] and 1.2-8.9 in patients after TUR alone [9,21,22,26,29].…”