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Effectiveness of an Immediate Mitomycin C Instillation in Patients with Superficial Bladder Cancer Receiving Periodic Mitomycin C Instillation

대한비뇨기과학회지 2011년 52권 5호 p.323 ~ 326
정석진 ( Jung Seok-Jin ) - Keimyung University School of Medicine Dongsan Medical Center Department of Urology

장혁수 ( Chang Hyuk-Soo ) - Keimyung University School of Medicine Dongsan Medical Center Department of Urology
박철희 ( Park Choal-Hee ) - Keimyung University School of Medicine Dongsan Medical Center Department of Urology
김천일 ( Kim Chun-Il ) - Keimyung University School of Medicine Dongsan Medical Center Department of Urology
김병훈 ( Kim Byung-Hoon ) - Keimyung University School of Medicine Dongsan Medical Center Department of Urology

Abstract


Purpose: We analyzed the impact of immediate intravesical mitomycin C instillation after transurethral resection of the bladder (TURB) on tumor recurrence and progression in patients with periodic mitomycin C instillation.

Materials and Methods: Between June 2000 and June 2006, a retrospective study was performed in a total of 115 patients with primary bladder tumors receiving a 6-week course of mitomycin C instillation after TURB. The patients were assigned to two groups: 53 patients in the immediate mitomycin C (I-MMC) group were treated by immediate instillation of mitomycin C after TURB and periodic instillation (6 times, 1 time per week), and 62 patients in the MMC group received only periodic instillation. Tumor recurrence and progression were compared in the two groups.

Results: During the mean follow-up period of 46.5 months in the I-MMC group and 47.2 months in the MMC group, early recurrence (within 1 year) occurred in 6 of 53 patients (11.3%) in the I-MMC group and in 18 of 62 patients (29.0%) in the MMC group (p<0.02). Although a significantly lower early recurrence rate was observed in the I-MMC group, this difference was not significant for recurrence within 2 or 3 years or for total recurrence. Progression was not significantly different between the two groups regarding the early and total period.

Conslusions: Our study confirmed the positive effect of a single, immediate mitomycin C instillation in patients with non-muscle-invasive bladder tumors who received periodic mitomycin C instillation. This benefit was limited to early recurrence and was not maintained with long-term follow-up. This approach can be an alternative to periodic mitomycin C instillation without immediate instillation.

키워드

Intravesical instillation; Mitomycin; Urinary bladder neoplasms
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