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Erschienen in: World Journal of Urology 4/2011

01.08.2011 | Original Article

Long-term experience with early single Mitomycin C instillations in patients with low-risk non-muscle-invasive bladder cancer: prospective, single-centre randomised trial

verfasst von: Cosimo De Nunzio, Antonio Carbone, Simone Albisinni, Giorgio Alpi, Andrea Cantiani, Marcello Liberti, Andrea Tubaro, Francesco Iori

Erschienen in: World Journal of Urology | Ausgabe 4/2011

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Abstract

Purpose

To study the benefits of a single, early, intravesical instillation of mitomycin C(MMC) after transurethral bladder resection (TURB) in patients with low-risk non-muscle-invasive bladder cancer (NMIBC).

Methods

In this prospective randomised single-centre trial, 211 patients with primary and low-risk tumours were enrolled between 2000 and 2009. Patients were randomly allocated to receive MMC intravesically within 24 h of TUR or no further treatment. The primary end point was recurrence rate reduction.

Results

A total of 202 patients (97 in the MMC group and 105 in the control group) remained for analysis after exclusions. Median age was 61 years (IQR 42–78), and median follow-up was 90 months (IQR 3–112). No significant differences for patients’ characteristics were observed between the two groups. During the study period, 10% (10/97) of the patients in the MMC group and 43% (46/105) in the control group experienced a recurrence (P = 0.0001). Four patients in the MMC group and 11 (P = 0.008) in the control group experienced an early recurrence (within 2 years). One patient in the control group presented a tumour progression (T2G3). MMC treatment was associated with a 31% absolute risk reduction of recurrence and a 3.26 numbers needed to treat to prevent one recurrence.

Conclusions

In this single-centre, long-term follow-up, experience a single, early instillation of MMC after TUR for low-risk NMIBC is associated with a significant reduction in risk of early and late recurrences.
Literatur
1.
Zurück zum Zitat Colombel M, Soloway M, Akaza H, Bohle A, Palou J, Buckley R, Lamm D, Brausi M, Witjes JA, Persad R (2008) Epidemiology, staging, grading, and risk stratification of bladder cancer. Eur Urol Suppl 7(10):618–626. doi:10.1016/j.eursup.2008.08.002 CrossRef Colombel M, Soloway M, Akaza H, Bohle A, Palou J, Buckley R, Lamm D, Brausi M, Witjes JA, Persad R (2008) Epidemiology, staging, grading, and risk stratification of bladder cancer. Eur Urol Suppl 7(10):618–626. doi:10.​1016/​j.​eursup.​2008.​08.​002 CrossRef
2.
Zurück zum Zitat Kirkali Z, Chan T, Manoharan M, Algaba F, Busch C, Cheng L, Kiemeney L, Kriegmair M, Montironi R, Murphy WM, Sesterhenn IA, Tachibana M, Weider J (2005) Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 66(6 Suppl 1):4–34. doi:10.1016/j.urology.2005.07.062 Kirkali Z, Chan T, Manoharan M, Algaba F, Busch C, Cheng L, Kiemeney L, Kriegmair M, Montironi R, Murphy WM, Sesterhenn IA, Tachibana M, Weider J (2005) Bladder cancer: epidemiology, staging and grading, and diagnosis. Urology 66(6 Suppl 1):4–34. doi:10.​1016/​j.​urology.​2005.​07.​062
4.
Zurück zum Zitat van Rhijn BW, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, Witjes JA, Zlotta AR (2009) Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol 56(3):430–442. doi:10.1016/j.eururo.2009.06.028 PubMedCrossRef van Rhijn BW, Burger M, Lotan Y, Solsona E, Stief CG, Sylvester RJ, Witjes JA, Zlotta AR (2009) Recurrence and progression of disease in non-muscle-invasive bladder cancer: from epidemiology to treatment strategy. Eur Urol 56(3):430–442. doi:10.​1016/​j.​eururo.​2009.​06.​028 PubMedCrossRef
5.
Zurück zum Zitat Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, Newling DW, Kurth K (2006) Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49(3):466–465. doi:10.1016/j.eururo.2005.12.031. Discussion 475–467 Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, Newling DW, Kurth K (2006) Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol 49(3):466–465. doi:10.​1016/​j.​eururo.​2005.​12.​031. Discussion 475–467
6.
Zurück zum Zitat Gudjonsson S, Adell L, Merdasa F, Olsson R, Larsson B, Davidsson T, Richthoff J, Hagberg G, Grabe M, Bendahl PO, Mansson W, Liedberg F (2009) Should all patients with non-muscle-invasive bladder cancer receive early intravesical chemotherapy after transurethral resection? The results of a prospective randomised multicentre study. Eur Urol 55(4):773–780. doi:10.1016/j.eururo.2009.01.006 PubMedCrossRef Gudjonsson S, Adell L, Merdasa F, Olsson R, Larsson B, Davidsson T, Richthoff J, Hagberg G, Grabe M, Bendahl PO, Mansson W, Liedberg F (2009) Should all patients with non-muscle-invasive bladder cancer receive early intravesical chemotherapy after transurethral resection? The results of a prospective randomised multicentre study. Eur Urol 55(4):773–780. doi:10.​1016/​j.​eururo.​2009.​01.​006 PubMedCrossRef
7.
Zurück zum Zitat Sylvester RJ, Oosterlinck W, van der Meijden AP (2004) A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol 171(6 Pt 1):2186–2190, quiz 2435 Sylvester RJ, Oosterlinck W, van der Meijden AP (2004) A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol 171(6 Pt 1):2186–2190, quiz 2435
8.
Zurück zum Zitat Solsona E, Iborra I, Ricos JV, Monros JL, Casanova J, Dumont R (1999) Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 161(4):1120–1123PubMedCrossRef Solsona E, Iborra I, Ricos JV, Monros JL, Casanova J, Dumont R (1999) Effectiveness of a single immediate mitomycin C instillation in patients with low risk superficial bladder cancer: short and long-term followup. J Urol 161(4):1120–1123PubMedCrossRef
9.
Zurück zum Zitat Oosterlinck W, Kurth KH, Schroder F, Bultinck J, Hammond B, Sylvester R (1993) A prospective european organization for research and treatment of cancer genitourinary group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single stage Ta, T1 papillary carcinoma of the bladder. J Urol 149(4):749–752PubMed Oosterlinck W, Kurth KH, Schroder F, Bultinck J, Hammond B, Sylvester R (1993) A prospective european organization for research and treatment of cancer genitourinary group randomized trial comparing transurethral resection followed by a single intravesical instillation of epirubicin or water in single stage Ta, T1 papillary carcinoma of the bladder. J Urol 149(4):749–752PubMed
10.
Zurück zum Zitat Bouffioux C, Kurth KH, Bono A, Oosterlinck W, Kruger CB, De Pauw M, Sylvester R (1995) Intravesical adjuvant chemotherapy for superficial transitional cell bladder carcinoma: results of 2 european organization for research and treatment of cancer randomized trials with mitomycin C and doxorubicin comparing early versus delayed instillations and short-term versus long-term treatment. European organization for research and treatment of cancer genitourinary group. J Urol 153(3 Pt 2):934–941PubMed Bouffioux C, Kurth KH, Bono A, Oosterlinck W, Kruger CB, De Pauw M, Sylvester R (1995) Intravesical adjuvant chemotherapy for superficial transitional cell bladder carcinoma: results of 2 european organization for research and treatment of cancer randomized trials with mitomycin C and doxorubicin comparing early versus delayed instillations and short-term versus long-term treatment. European organization for research and treatment of cancer genitourinary group. J Urol 153(3 Pt 2):934–941PubMed
11.
Zurück zum Zitat Berrum-Svennung I, Granfors T, Jahnson S, Boman H, Holmang S (2008) A single instillation of epirubicin after transurethral resection of bladder tumors prevents only small recurrences. J Urol 179(1):101–105. doi:10.1016/j.juro.2007.08.166. Discussion 105–106 Berrum-Svennung I, Granfors T, Jahnson S, Boman H, Holmang S (2008) A single instillation of epirubicin after transurethral resection of bladder tumors prevents only small recurrences. J Urol 179(1):101–105. doi:10.​1016/​j.​juro.​2007.​08.​166. Discussion 105–106
12.
Zurück zum Zitat Tolley DA, Parmar MK, Grigor KM, Lallemand G, Benyon LL, Fellows J, Freedman LS, Hall RR, Hargreave TB, Munson K, Newling DW, Richards B, Robinson MR, Rose MB, Smith PH, Williams JL, Whelan P (1996) The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of follow up. J Urol 155(4):1233–1238PubMedCrossRef Tolley DA, Parmar MK, Grigor KM, Lallemand G, Benyon LL, Fellows J, Freedman LS, Hall RR, Hargreave TB, Munson K, Newling DW, Richards B, Robinson MR, Rose MB, Smith PH, Williams JL, Whelan P (1996) The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of follow up. J Urol 155(4):1233–1238PubMedCrossRef
Metadaten
Titel
Long-term experience with early single Mitomycin C instillations in patients with low-risk non-muscle-invasive bladder cancer: prospective, single-centre randomised trial
verfasst von
Cosimo De Nunzio
Antonio Carbone
Simone Albisinni
Giorgio Alpi
Andrea Cantiani
Marcello Liberti
Andrea Tubaro
Francesco Iori
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
World Journal of Urology / Ausgabe 4/2011
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-011-0691-2

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