BACKGROUND: A recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract is not rarely observed. A prospective randomized study was conducted to examine the significance of prophylactic intravesical instillation of mitomycin C (MMC) and cytosine arabinoside (Ara-C) to prevent recurrent bladder tumors after surgery for superficial transitional cell carcinoma of the upper urinary tract. METHODS: The patients were randomized into an instillation group, who received postoperative intravesical instillation of MMC (20 mg) and Ara-C (200 mg) 28 times over a period of 2 years, and a non-instillation group. The non-recurrence rate was then compared between the groups. RESULTS: Of the 27 patients registered, 25 patients (13 with instillation and 12 without instillation) were able to be evaluated, with a median follow-up period of 45 months. The non-recurrence rate of bladder tumors in the instillation group was higher than that in the non-instillation group. Although the difference was not statistically significant, the P-value (P = 0.079) demonstrated a strong trend. When any possible bias was allowed for a multivariate analysis, the difference was almost significant (P = 0.0567). No patients withdrew from this study due to any side-effects. CONCLUSION: The postoperative instillation of MMC and Ara-C may be a useful approach for reducing the recurrence of bladder tumors after surgery for upper urinary tract tumors.
RCT Entities:
BACKGROUND: A recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract is not rarely observed. A prospective randomized study was conducted to examine the significance of prophylactic intravesical instillation of mitomycin C (MMC) and cytosine arabinoside (Ara-C) to prevent recurrent bladder tumors after surgery for superficial transitional cell carcinoma of the upper urinary tract. METHODS: The patients were randomized into an instillation group, who received postoperative intravesical instillation of MMC (20 mg) and Ara-C (200 mg) 28 times over a period of 2 years, and a non-instillation group. The non-recurrence rate was then compared between the groups. RESULTS: Of the 27 patients registered, 25 patients (13 with instillation and 12 without instillation) were able to be evaluated, with a median follow-up period of 45 months. The non-recurrence rate of bladder tumors in the instillation group was higher than that in the non-instillation group. Although the difference was not statistically significant, the P-value (P = 0.079) demonstrated a strong trend. When any possible bias was allowed for a multivariate analysis, the difference was almost significant (P = 0.0567). No patients withdrew from this study due to any side-effects. CONCLUSION: The postoperative instillation of MMC and Ara-C may be a useful approach for reducing the recurrence of bladder tumors after surgery for upper urinary tract tumors.
Authors: Georgios Gakis; Tina Schubert; Mehrdad Alemozaffar; Joaquim Bellmunt; Bernard H Bochner; Steven A Boorjian; Siamak Daneshmand; William C Huang; Tsunenori Kondo; Badrinath R Konety; Maria Pilar Laguna; Surena F Matin; Arlene O Siefker-Radtke; Shahrokh F Shariat; Arnulf Stenzl Journal: World J Urol Date: 2016-04-04 Impact factor: 4.226
Authors: Eu Chang Hwang; Niranjan J Sathianathen; Jae Hung Jung; Myung Ha Kim; Philipp Dahm; Michael C Risk Journal: Cochrane Database Syst Rev Date: 2019-05-18
Authors: Anil Kapoor; Shawn Dason; Christopher B Allard; Bobby Shayegan; Louis Lacombe; Ricardo Rendon; Niels-Erik Jacobsen; Adrian Fairey; Jonathan Izawa; Peter Black; Simon Tanguay; Joseph Chin; Alan So; Jean-Baptiste Lattouf; David Bell; Fred Saad; Darrell Drachenberg; Ilias Cagiannos; Yves Fradet; Abdulaziz Alamri; Wassim Kassouf Journal: Can Urol Assoc J Date: 2014-11 Impact factor: 1.862