Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
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.
OBJECTIVE:
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.
RESULTS:
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).
CONCLUSION:
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.