Also available in: Español
Rev Mex Urol. 2017 July;77(4):233-238. DOI: https://doi.org/10.24245/revmexurol.v77i4.1070
Velázquez-Macías RF, Monroy Bolaños GE
Urology Service, Hospital Regional Licenciado Adolfo López Mateos (ISSSTE). Mexico City, Mexico.
BACKGROUND: Bladder cancer is the second most frequent urologic cancer worldwide (3.3%). Transurethral resection of bladder tumor followed by adjuvant intravesical therapy with mitomycin C is a therapeutic option when the cancer is non-muscle-invasive.
OBJECTIVE: The aim of the present study was to evaluate the efficacy of mitomycin C after transurethral resection of superficial bladder tumor and to identify the risk factors associated with tumor recurrence.
MATERIALS AND METHODS: A retrospective, analytic, observational, and longitudinal study was conducted on patients with superficial bladder cancer that underwent transurethral resection of bladder tumor and then received intravesical therapy with mitomycin C. The patients were divided into group 1: with no tumor recurrence and group 2: with tumor recurrence. The study variables were: age, sex, tumor-associated symptomatology, histologic grade, recurrence, and adverse effects from mitomycin C. The Student’s t test, χ2, and Spearman’s rho were the statistical tests used for the data analysis.
RESULTS: There were 20 patients in group 1 and 8 in group 2. The mean age of the group 1 patients was 67.7 and 66.8 years, for women and men, respectively, and was 66 and 62.8 years in group 2 (χ2, p = 0.410). Mean follow-up in group 1 was 41.4 months, and 43.8 months in group 2. Male sex predominated in group 1 (60%) and female sex in group 2 (62.25%), with no statistical difference between the two groups (χ2, p = 0.410). The mean presentation time of recurrence was 10.3 months. Symptoms improved in G1 after treatment. There was clinical improvement in dysuria (chi-square, p = 0.006), urethral burning sensation (χ2, p = 0.005), and pollakiuria (χ2, p = 0.030) that was statistically significant. In the G2 group hematuria, urgency, nocturia, and suprapubic pain decreased and dysuria, urethral burning sensation, and pollakiuria remained unchanged. Bladder tenesmus increased, but without statistical significance. In relation to tumor recurrence, there was a positive association with hematuria (Spearman’s rho, p = 0.000), dysuria (Spearman’s rho, p = 0.004), urethral burning sensation (Spearman’s rho, p = 0.004), and pollakiuria (Spearman’s rho, p = 0.030) after treatment. There was also a positive association with pretreatment suprapubic pain (Spearman’s rho, p = 0.026) and tumor stage (Spearman’s rho, p = 0.001). Fifteen patients (53.6%) had adverse effects from mitomycin C and the most frequent was urinary tract infection, followed by urethral stricture.
CONCLUSIONS: Mitomycin C was effective for controlling and reducing symptoms related to bladder cancer.
KEYWORDS: Bladder cancer; Mitomycin C; Recurrence
Dr. Rafael Francisco Velázquez-Macías