Mitomycin-C in superficial bladder cancer. Is long-term maintenance therapy worthwhile after initial treatment?
A total of 72 patients with recurrent superficial transitional cell carcinoma of the bladder (TCC) were treated with 40 mg intravesical instillations of mitomycin-C (MMC) weekly for 10 weeks, followed by monthly maintenance doses. With a mean follow-up period of 41 months, 30 patients (42%) had a complete and sustained response after the initial treatment course, and a further 14 (19%) achieved a complete response on maintenance therapy. Sixteen patients (22%) continued to have recurrent tumours and the remaining 12 (17%) developed recurrent tumours after an initial complete response. Of these, 4 patients with carcinoma in situ (CIS) showed symptomatic improvement, but the histological changes persisted and all of those with tumours > 2 cm in size did not respond. We conclude that maintenance treatment with MMC is beneficial in superficial bladder cancer but is of limited value in the presence of bulky tumours or CIS.
Hamdy
F C
FC
Department of Urology, Royal Hallamshire Hospital, Sheffield.
Hastie
K J
KJ
Kerry
R
R
Williams
J L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
D016685:Mitomycin