Mp43-20 single-Dose Perioperative Mitomycin vs. Thiotepa After Transurethral Resection of Low Grade Non-Invasive Bladder Cancer

Abstract

INTRODUCTION AND OBJECTIVES: Risk stratification into low-, intermediate-and high-risk groups has been widely used for the management of patients with non-muscle-invasive bladder cancer (NMIBC). Although low-and high-risk groups have been clearly classified, the intermediate-risk group has traditionally included heterogeneous patients which do not fit into either of these groups, resulting in uncertainty regarding its prognosis and adjuvant therapy. Whereas small, Ta low-grade recurrence does not present an immediate danger to the patient, recurrence of high-risk tumors should be early detected during the follow-up of intermediate-risk NMIBC patients. Here, we aimed to substratify intermediate-risk NMIBC patients based on the prediction of high-risk recurrence (HRR).METHODS: This study included 645 primary NMIBC patients who underwent TURBT at a single institution from 2010 to 2018. Risk stratification was according to the EAU guidelines. Of the 645 patients, 330 patients with intermediate-risk NMIBC were in analysis. HRR was defined as high-risk non-muscle-invasive, muscle-invasive, or metastatic recurrences. Factors predicting HRR were explored using the Cox proportional hazards model. RESULTS: Of the total patients, 146 (44%) patients recurred. HRR was developed in 37 (11%) patients, which included 34 (10%) with high-risk non-muscle-invasive recurrence and three (1%) with muscle invasive recurrence. On multivariate analysis, bladder neck involvement (BNI) (HR 2.84, p [ 0.020) and positive urine cytology (PUC) (HR 3.82, p <0.001) were independent predictors for HRR. The 5-yr HRRfree survival (HRRFS) rate was 71% in 82 (25%) patients with either BNI or PUC. Meanwhile, in 248 (75%) patients without BNI and PUC, the 5-yr HRRFS rate was 93% (p <0.001), and no patient eventually progressed to muscle-invasive disease and died of the disease.CONCLUSIONS: In intermediate-risk NMIBC, most of the patients without bladder neck involvement and positive urine cytology were free from high-risk recurrence. Thus, they may safely avoid adjuvant intravesical therapy and intensive follow-up by cystoscopy.

Proteomic Profiling of Endothelial Cells Exposed to Mitomycin C: Key Proteins and Pathways Underlying Genotoxic Stress-Induced Endothelial Dysfunction

“…MMC is a chemotherapy and anti-fibrotic drug characterized by clastogenic activity [37][38][39][40][41][42][43][44]. The ability of MMC to induce genotoxic stress is due to the peculiarities of its metabolism.…”

Perfusion drugs for non‑muscle invasive bladder cancer (Review)

“…ThioTEPA can also be used in combination with other bladder instillation drugs. A previous study has reported that bladder instillation of Bacillus Calmette-Guérin (BCG) is associated with a lower recurrence rate of BC in the group using BCG, as compared with groups undergoing instillation of other drugs ( 8 ). However, the adverse effects of BCG instillation (including difficulty in urination or hematuria) should not be underestimated, and therefore a strategy of combining thioTEPA with BCG is occasionally adopted, which ensures the therapeutic efficacy and reduces the adverse effects ( 9 ).…”

Atorvastatin Can Modulate DNA Damage Repair in Endothelial Cells Exposed to Mitomycin C

“…Mitomycin C (MMC) is a chemotherapy and anti-fibrotic drug used in cancer therapy and various eye surgeries [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. In mammalian cells, MMC undergoes reductive activation to form mitosene [ 9 , 10 ], which reacts via N-alkylation with 7-N-guanine nucleotide residues in the minor groove of DNA followed by DNA crosslinking [ 11 ], replication and transcription arrest, and finally, apoptosis [ 12 ].…”