The Effect of Postoperative Intravesical BCG and Mitomycin C Therapy on Recurrence of Non-Muscle Invasive Bladder Cancer

Abstract

Background: We aimed to evaluate the efficacy of two mostly used intravesical agents, bacillus Calmette-Guerin (BCG) and mitomycin C (MMC), for tumor recurrence in non-muscle invasive bladder cancer.

Methods: Between January 2002 and April 2008, we performed TUR-BT on 127 patients whose pathology results were superficial bladder cancer. Patient files are examined retrospectively. Forty-one patients were treated with intravesical BCG once a week for 6 weeks, and then monthly up to 1 year from 14th day postoperatively. Twenty-six patients were treated with intravesical MMC, from first 6 h postoperatively and once a week for 8 weeks.

Results: There was no statistically significant difference between groups for age, gender, number of tumors, tumor size, and pathological staging (P = 0.354, P = 0.315, P = 0.457, P = 0.302, and P = 0.692, respectively). In BCG group, 13 (31.7%) patients recurred. For MMC group, recurrence was seen in 9 (34.6%) patients. One and three years disease free survival rates were 92.7% and 75.7% in BCG group, and 76.9% and 62.9% in MMC group. In BCG group, estimated recurrence-free survival was 58.1 months, and it was 34.6 months for MMC group. Estimation difference among groups was statistically significant (P = 0.017).

Conclusions: Intravesical adjuvant BCG maintenance therapy is more effective for tumor recurrence than intravesical MMC therapy.

World J Nephrol Urol. 2013;2(2):65-69
doi: http://dx.doi.org/10.4021/wjnu128e