LONG-TERM FOLLOW-UP OF PATIENTS WITH SUPERFICIAL TRANSITIONAL-CELL CARCINOMA OF THE URINARY-BLADDER TREATED BY INTRAVESICAL MITOMYCIN-C

Prophylactic intravesical chemotherapy (IVC) reduces recurrence rates of superficial transitional cell carcinoma (TCC) of the urinary bladde r. The patient cohort existed of 86 individuals (stage TaNOMO or T1NOM O) superficial carcinoma of various grades of malignancy. Following in itial transuretheral resection or diagnostic cystoscopy, mitomycin C ( MMC), 20 mg dissolved in 50 ml saline, was instilled intravesically by catheter over 1 hr at 2-week intervals, initially and then four more times followed by diagnostic cystoscopy (one course = 12 weeks). Two s imilar courses were administered thereafter for a total period of 36 w eeks. For patients in remission, installations continued in monthly fr actionations for 9 more months (cystoscopy every 3 months) and then at 2-month intervals for 12 more months (cystoscopy every 6 months). Whe n cystoscopy revealed recurrence, IVC was repeated from the beginning. No symptoms of MMC-related toxicity were observed. Cystoscopic follow -up evaluations showed a complete response rate of 84% at 3 years and 81% at 5 years after initial therapy. Twenty-seven patients who had no t responded to previous treatment with other drugs responded to MMC. ( C) 1995 Wiley-Liss, Inc.