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

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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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University “La Sapienza”, Rome, Italy

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

  2. Ospedale Sant’Andrea, University “La Sapienza” Roma, Via di Grottarossa 1035, 00189, Rome, Italy

    Cosimo De Nunzio

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  1. Cosimo De Nunzio
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  2. Antonio Carbone
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  3. Simone Albisinni
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  4. Giorgio Alpi
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  5. Andrea Cantiani
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  6. Marcello Liberti
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  7. Andrea Tubaro
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  8. Francesco Iori
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Correspondence to Cosimo De Nunzio.

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De Nunzio, C., Carbone, A., Albisinni, S. et al. Long-term experience with early single Mitomycin C instillations in patients with low-risk non-muscle-invasive bladder cancer: prospective, single-centre randomised trial. World J Urol 29, 517–521 (2011). https://doi.org/10.1007/s00345-011-0691-2

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  • DOI: https://doi.org/10.1007/s00345-011-0691-2

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