Iraqi Postgraduate Medical Journal

Abstract

BACKGROUND:
We determined if immediate instillation chemotherapy after transurethral resection (TUR) decrease the risk of recurrence andor progression in patient with stage Ta T1 bladder cancer.
OBJECTIVES:
This study has been designed to analyze the impact of a single immediate mitomycin C instillation after transurethral resection of bladder cancer on recurrence and progression rates in patients with low risk superficial bladder cancer.
METHODS:
A total of 50 patients with low risk superficial bladder cancer were included in a prospective randomized controlled trial. All patients had a 3 cm. or less single, papillary bladder tumer. The tumor was completely resected before patients were randomized into 2 arms of no further treatment (control group) and a single immediate instillation (usually within 6 hours) of 40 mg. mitomycin c (mitomycin c group). Median follow up was 24 months .The events studied were the recurrence free rate, the recurrence rate/year, and the number of new tumors developing /year.
RESULTS:
At 24-month follow-up the recurrence-free rate was significantly increased (84.7% VS 54.2%). Recurrence (15.3% VS 45.8%), and recurrence per year rate (7% VS 20%) and tumor per year rate(11% VS 33%) were significantly decreased in the mitomycin c compared to the control group.
CONCLUSION:
This study confirms the positive effect of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer. Thus, this approach is an alternative to observation. This study also suggests cell implantation as a mechanism of early recurrence can be controlled with a single immediate mitomycin c instillation.