title: The effect of intravesical mitomycin C on recurrence of newly diagnosed superficial bladder cancer: a further report with 7 years of follow up.
abstract: OBJECTIVE
  We determined the role, if any, of 1 and 5 instillations of intravesical mitomycin C in the treatment of newly diagnosed superficial bladder cancer.
  
  
  METHODS
  A multicenter randomized clinical trial was done involving 502 patients with newly diagnosed superficial bladder cancer. After complete transurethral resection patients with newly diagnosed superficial bladder cancer. After complete resection patients were randomized into 1 of 3 treatment arms: no further treatment, 1 instillation of mitomycin C at resection and 1 instillation at resection and at 3-month intervals for 1 year (total 5 instillations). The dose of mitomycin C used was 40 mg./40 ml. water. End points were interval to first superficial recurrence, recurrence rate (defined as the number of positive cystoscopies per year) and progression-free interval rate (progression defined as the development of muscle invasive or metastatic disease, or death from bladder cancer).
  
  
  RESULTS
  After median followup of 7 years 1 and 5 instillations of mitomycin C resulted in decreased recurrence rates and increased recurrence-free interval. The benefit of mitomycin C was observed in patients at low, medium and high risk for subsequent recurrence. There was suggestive but not conclusive evidence that 5 instillations of mitomycin C offered a slight advantage over 1 instillation.
  
  
  CONCLUSIONS
  Our analysis confirms the positive benefit of mitomycin C to decrease the number of subsequent recurrences and increase the recurrence-free interval.
authors.affiliation: Medical Research Council Cancer Trials Office, Cambridge, United Kingdom.
authors.forename: D A
authors.initials: DA
authors.lastname: Tolley
authors.forename: M K
authors.initials: MK
authors.lastname: Parmar
authors.forename: K M
authors.initials: KM
authors.lastname: Grigor
authors.forename: G
authors.initials: G
authors.lastname: Lallemand
authors.forename: L L
authors.initials: LL
authors.lastname: Benyon
authors.forename: J
authors.initials: J
authors.lastname: Fellows
authors.forename: L S
authors.initials: LS
authors.lastname: Freedman
authors.forename: K M
authors.initials: KM
authors.lastname: Grigor
authors.forename: R R
authors.initials: RR
authors.lastname: Hall
authors.forename: T B
authors.initials: TB
authors.lastname: Hargreave
authors.forename: K
authors.initials: K
authors.lastname: Munson
authors.forename: D W
authors.initials: DW
authors.lastname: Newling
authors.forename: B
authors.initials: B
authors.lastname: Richards
authors.forename: M R
authors.initials: MR
authors.lastname: Robinson
authors.forename: M B
authors.initials: MB
authors.lastname: Rose
authors.forename: P H
authors.initials: PH
authors.lastname: Smith
authors.forename: J L
authors.initials: JL
authors.lastname: Williams
authors.forename: P
authors.initials: P
authors.lastname: Whelan
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009364:Neoplasm Recurrence, Local; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin