Effects of intravesical mitomycin and distilled water on recurrence after TUR-TM in Ta, T1 tumors

Abstract

Aim The elimination of floating tumor cells inside bladder during and after transurethral resection of tumor (TUR-Tm) due to the cytolytic effects of distilled water has been demonstrated. In this study, our aim is to compare the effects of diluted mitomycin-C (MMC) with distilled water and/or saline with distilled water alone on early recurrence risk. Material and Methods 43 patients with Ta-T1 stage transitional cell carcinoma (TCC) have been investigated in 4 groups. MMC 40mg diluted with distilled water and/or saline was applied to the first two groups. Distilled water and saline alone were administered to the other two groups. All instillations were done intravesically within 2-4 hours after resection and kept inside for 2 hours. Patients were controlled in 3, 6, 9 and 12th months by cystoscopic evaluation. Results No differences were obtained among patients in the study groups in terms of tumor characteristics. Recurrence was observed only in 5 patients (11.6%) during 12 month follow-up period. Although, there was no recurrence in group I (MMC+ saline) and III (distilled water), recurrence was detected in group IV (saline) (3 patients, 27.3%) at 3th month and in group II (MMC+ distilled water) (2 patients, 20%) at 6th month (p=0.102). Conclusions According to our preliminary results there were no significant differences in terms of development of recurrence among treatment groups. Clinical clues have been obtained about non-chemotherapeutic agents, such as distilled water, might be effective in preventing recurrence of the tumor. Supporting our data with more number of patients and longer follow-up was concluded for further researches.