The Results of Eight Years' Clinical Experience with Intravesical Mitomycin C Plus Hyperthermia for the Treatment of Superficial Bladder Tumors

Kim, Il Whan; Lee, Kwang Soo

Abstract

PURPOSE: A non-randomized study was performed to assess the efficacy of Mitomycin C (MMC) plus hyperthermia as a primary therapy after an initial transurethral resection (TUR) for treating superficial bladder tumors or as a salvage modality for recurrent T1 tumors after adequate BCG therapy.
MATERIALS AND METHODS
A total of 31 patients from Nov. 1992 to Aug. 2001 with follow-up of 11 to 94 months (mean 27.4) were enrolled in this study. Of the 31 patients, 27 underwent MMC plus hyperthermia as the primary agent after TURB and among those 27 patients 7 had a tumor recurrence and were allocated to receive BCG. Of the 31 patients, 4 were given BCG initially, and at the time of first or second recurrence, MMC plus hyperthermia was attempted.
RESULTS
Of the 27 patients who received MMC plus hyperthermia, 20 (74%) responded to the initial therapy without a local recurrence and the mean follow-up was 26.4 months with a range of 12 to 94 months. Seven patients had a tumor recurrence and the median interval to recurrence was 21.6 months. Of the 7 patients who had a tumor recurrence, the histology (stage or grade) had changed at the time of the recurrence in 4 (57%). Four patients who received BCG as an initial therapy had a tumor recurrence and the mean interval to recurrence was 14.5 months. These patients were treated with MMC plus hyperthermia and 3 those patients remain free of recurrence with a follow-up of 11 to 71 months. One of those patients underwent a cystectomy and urinary diversion.
CONCLUSIONS
MMC plus hyperthermia is a viable option for appropriately selected patients who developed recurrent superficial bladder tumors after adequate BCG therapy.