The Effect of Intravesical Single-Dose Mitomycin C in Recurrent Superficial Bladder Cancer

Abstract

Objectives: This study was designed to evaluate the efficacy of the intravesical instillation of single-dose Mitomycin C post-ablation of purely recurrent tumours. Patients and methods: Two patient groups with small-volume, low-grade (1 or 2), superficial (pTa) recurrent disease were studied. Sixty-seven patients at one institution received a single intravesical dose of Mitomycin C following tumour ablation using a Holmium YAG Laser. The other institution provided a control patient group of 68 patients treated with laser ablation alone. Patients were reviewed with regular flexible cystoscopies throughout the study period. Results: The groups were matched for age and the number and grade of tumours. Recurrence rates were lower, yet not to statistical significance, in the group receiving Mitomycin C post-intervention (48% vs. 62% ( p= 0.14) at 12 months and 76% vs. 82% at 24 months ( p = 0.64)). The observed beneficial effect at 12 months appeared to depreciate by 24 months. There was no significant improvement in the recurrence-free interval for the Mitomycin C group (log rank test p = 0.28). Conclusions: This study has failed to demonstrate a beneficial trend for the use of single-dose of Mitomycin C after ablation of recurrent superficial bladder cancer. Further evaluation in the form of a prospective trial is indicated.