The treatment of non-invasive bladder tumours with transurethral resection and intravesical instillation of Mitomycin C

Abstract

Author(s): Nuraj Petrit*, Gllareva Bashkim and Beqiri Agron

Background: Approximately 75%-80% of the cases with bladder cancers are discovered when the tumor is located on the lamina mucosa (Ta, Tis), or on the lamina propria (T1). Whilst 15%-25 % of bladder cancers are discovered when the tumour has invasive evolution and has evolved also the muscle extent and on, or has given metastases on the lymphatic glands.

Objective: Is it effective Mitomycin in the treatment of non-invasive bladder tumours Ta-T1 after transurethral resection.

Material and Methods: The research was conducted with patients of the Urology Clinic, University Clinical Centre of Kosovo, in Prishtina. The study included 108 patients with non-invasive bladder tumours Ta T1. After TURBT, we applied intravesical instillation Mitomycin C 40 mg within the first 6 hours of the transurethral resection. After the histopathological result, a week after the TURBT, we instilled Mitomycin C once a week for 6 weeks, then once a month for 2 months. The follow up was 36 months. From the statistical parameters, the structure index, arithmetic mean, and standard deviation were calculated. Qualitative data testing was done with X2 test.

Results: The study included 108 patients with bladder tumours of which 72.2% were male and 27.8% were female. X2-test showed statistically significant difference of cases by gender (X2=11.2, P=0.001). The age (mean± SD) was 63.1 ± 11.3 years. Current smokers were 63% of cases. Tumours grade were: PUNLMP 19.4%, low grade 58.3%, high grade 22.2% of cases. X2- test showed statistically significant difference (X2=11.2, P=0.001). Multifocality with tumours were 76.9% of solitary and 23.1% of multiple tumours. The tumours recurred in 41 patients (37.9%). Morphologically, of which 75% were defined with tumour size <3 cm and 25% with tumour size >3 cm. The tumour stage was as Ta 43.5% and T1 56.5% of cases.

Conclusion: The effective therapy for non-invasive bladder tumours (Ta-T1) is TURBT with intravesical instillation of Mitomycin C. Diagnosing these tumours at their early stages is the key for the best treatment and prognoses. Intravesical chemotherapy is safe and tolerable for non-invasive bladder tumours and has reduced tumour recurrence rates, especially when the grade is low.

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