Comparison of 1 Year Recurrent Rate in High-Risk of Recurrent Non-Muscle Invasive Bladder Cancer Who Had Received Induction Course of Intravesical BCG after TUR-BT Between Combination with Immediate Intravesical Mitomycin C and Induction Course of Intrave

Abstract

Comparison of 1 Year Recurrent Rate in High-Risk of Recurrent Non-Muscle Invasive Bladder Cancer Who Had Received Induction Course of Intravesical BCG after TUR-BT Between Combination with Immediate Intravesical Mitomycin C and Induction Course of Intravesical BCG Alone

Objective: To compare a recurrent rate within the first year after TUR-BT between immediate intravesical Mitomycin C with induction course of intravesical BCG and induction course of intravesical BCG alone in high risk group of non-muscle invasive bladder cancer.
Materials and methods: A retrospective study between January 2007 and December 2010, 138 patients who underwent complete induction course of intravesical BCG and followed surveillance cystoscopy every 3 months at least 1 year after TUR-BT were identified and divided in two groups, immediate intravesical Mitomycin C plus induction course of intravesical BCG (group 1) and induction course of intravesical BCG alone (group 2). The 1 year recurrent rate of tumor after TUR-BT was compared.
Results: One hundred thirty eight cases that were male 112 cases and female 26 cases completely collected in database. Mean age was 67.39 years and mean follow up time was 22 months. There were no differences between both groups in demographic data. (p value 0.430). The indications for induction course of intravesical BCG were tumor size more than 3 cm., number of tumor more than 3 sites, high grade tumor and history of tumor recurrent in 1 year ,which were no differences between both groups. (p value =0.032, 0.087, 0.065, 0.676 respectively). 21 cases of the 62 patients in group 1 (33.9%) had recurrent tumor and 31 cases of the 76 patients in group 2 (40.8%) had recurrent tumor. There were no differences in 1 year recurrent rate.
Conclusions: Although several studies showed effectiveness of immediate intravesical Mitomycin C plus induction course intravesical BCG superior to intravesical BCG alone, some studies did not show benefit from immediate intravesical Mitomycin C. In our study, immediate intravesical Mitomycin C plus induction course of intravesical BCG (group 1) and induction course of intravesical BCG alone (group 2) were comparable in 1 year recurrent rate for high risk group non-muscle invasive bladder cancer. There is no benefit in decreasing recurrent rate in 1 year but long term effect needed to be followed.