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A 6-month maintenance schedule of mitomycin C after radical nephroureterectomy for upper tract urothelial carcinoma for the prevention of intravesical recurrence: a retrospective, single center study

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Abstract

Purpose

To show the effect of a 6-month (4 times weekly followed by 5 times monthly) maintenance mitomycin C regimen on the prevention of intravesical recurrence (IVR) after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).

Methods

A total of 119 patients undergoing a RNU between 2007 and 2021 in a single center hospital were retrospectively reviewed. A total of 66 patients were eligible for further analysis. 27 patients received no post-operative MMC (median follow-up: 110 months) and 39 patients received a 6-month (4 times weekly, 5 times monthly) maintenance regimen of MMC (median follow up: 48 months). The primary outcome was the 1-, 2- and 5-year bladder recurrence free survival (BRFS).

Results

There was a significant difference (p = 0.001) in BRFS between the two groups. The 1-, 2, and 5-year BRFS for the MMC− group was 67%, 63% and 43%, respectively. The 1-, 2- and 5-year BRFS for the MMC + group was 95%, 86% and 86%, respectively. Univariate analysis showed no other potential prognostic factors that had a significant effect on the BRFS.

Conclusion

A 6-month maintenance schedule of MMC is effective at significantly reducing the risk of IVR after RNU for UTUC. We could not find any other significant prognostic factors to predict IVR.

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Data availability

The data that support the findings of this study are not openly available due to them containing information that could compromise research participant privacy and are available from the corresponding author upon reasonable request.

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Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Urology, OLVG, Amsterdam, The Netherlands

    Casper van Wijngaarden, Annebeth Evelien Cathelijn Ruiter & Brunolf Walther Lagerveld

  2. Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Mieke Theodora Jenneke Bus

Authors
  1. Casper van Wijngaarden
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  2. Mieke Theodora Jenneke Bus
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  3. Annebeth Evelien Cathelijn Ruiter
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  4. Brunolf Walther Lagerveld
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Correspondence to Casper van Wijngaarden.

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Research involving human participants

The study was approved by the institutional review board.

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van Wijngaarden, C., Bus, M.T.J., Ruiter, A.E.C. et al. A 6-month maintenance schedule of mitomycin C after radical nephroureterectomy for upper tract urothelial carcinoma for the prevention of intravesical recurrence: a retrospective, single center study. World J Urol 41, 1077–1083 (2023). https://doi.org/10.1007/s00345-023-04316-z

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  • DOI: https://doi.org/10.1007/s00345-023-04316-z

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