Topical chemoprophylaxis of superficial bladder cancer with mitomycin C and adjuvant hyaluronidase.
The effect of intravesical instillation of 200,000 IU hyaluronidase in addition to mitomycin C as chemoprophylaxis of superficial bladder cancer was evaluated. Based on our result of a previous study that this approach results in a significantly reduced recurrence rate (7.1 versus 32.1%), 43 patients undergoing transurethral resection of Ta-T1 tumors were retrospectively analyzed after a mean observation period of 48.5 months. During the 2 years of prophylactic therapy, tumor recurrence was seen in 6 patients (13.9%). Of the 37 patients who remained recurrence-free under treatment, 5 (13.5%) had recurrent tumors later during a mean observation period of 24.5 (18-42) months after treatment. These values are significantly lower than those obtained previously from a group of 63 patients treated with mitomycin alone, with recurrence rates of 33.3% during chemoprophylaxis and 26.2% thereafter (mean observation period 50.4 months). It appears that additive hyaluronidase enhances the local effect of mitomycin C in the intravesical chemoprophylaxis of bladder cancer, presumably by improving diffusion into the bladder mucosa and catalyzing the breakdown of a hyaluronic acid contained in a protective halo around malignant urothelial cells.
Höbarth
K
K
Department of Urology, University of Vienna Medical School, Austria.
Maier
U
U
Marberger
M
M
D000283:Administration, Intravesical; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage* / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D011182:Postoperative Care; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000453:epidemiology
D016685:Mitomycin; D006821:Hyaluronoglucosaminidase