Single early instillation of mitomycin C and urinary alkalinization in low-risk non-muscle-invasive bladder cancer: a preliminary study

Abstract

BackgroundThe purpose of this study was to determine the effectiveness of a single early instillation of mitomycin C (MMC) after transurethral resection of bladder tumor (TURBT) together with urinary alkalinization in patients with low-risk non-muscle-invasive bladder cancer (NMIBC).MethodsBetween February 2006 and November 2010, patients diagnosed as having a primary bladder tumor were randomized into standard and optimized treatment groups. The treatment groups were formed prospectively from patients with NMIBC according to results of pathological examination postoperatively, whereas the control group was formed retrospectively. Patients in the standard group (n = 11) were given intravesical MMC 40 mg in the first 6 hours after TURBT, while the patients in the optimized group (n = 15) underwent urinary alkalinization prior to MMC. In the control group (n = 23), no drug treatment was given. The patients were followed after surgery at months 3 and 12, and then annually for the first 5 years using cystoscopy and ultrasound. Time to recurrence and recurrence-free survival rates were calculated.ResultsThere were no statistically significant differences between the standard and optimized groups, between the control and optimized groups, or between the control and standard groups in terms of mean recurrence-free survival rates (P = 0.132, 0.645, and 0.173, respectively). The mean time to recurrence was 34.8 (range 28.5–41.1) months in the optimized group and 51.8 (range 44.3–59.2) months in the control group. There was no recurrence during the follow-up period in the standard group.ConclusionThe results of this preliminary study could not demonstrate the efficacy of urinary alkalinization before a single dose of early MMC following TURBT to increase the effectiveness of the MMC, so we did not continue the study further.

Mathematical model of MMC chemotherapy for non-invasive bladder cancer treatment

“…2. The prospective study of Ersoy et al (87), showed no recurrence of patients during the follow-up period of five years. Utilizing their dosage plan, the model attained a threshold of 2.14 × 10 7 [cells], corresponding to a diameter of 30.14[mm] (see Supplementary Figure S8).…”

“…In this paper, we propose theoretical explanation for the fact that still, a substantial percentage of patients fail the treatment (38)(39)(40)(41)(42)(43). It is possible that treatment failure results from tumor size, as described in the literature (86,87) and shown in Figure 5, or from an improper selection of the drug dose, m 0 , that is implicitly reflected in the drug instillation rate, m, of the model. In this context, improper is defined as a set of parameters that are theoretically patient-specific and do not meet the conditions required by this mathematical method for cure.…”

Pediatric Nurses’ Information and Applications Related To Ethical Codes

“…A total of nurses attending the courses at the specified dates and who agreed to participate in the study were included in the analysis. Data were collected through a questionnaire that we developed in accordance with current literature on nursing ethics ( 2 - 4 , 8 , 9 ). The questionnaire consisted of two parts and 46 items.…”

“…By laying out the liabilities that each individual physician or health practitioner has towards him or herself and his or her patients, applied ethics teaches that physician the behavior that is in line with his or her own values. It assists in the decisions they must make, as well as their fulfillment with the profession; furthermore, it helps them avoid causing patients harm ( 2 , 3 ). The Florence Nightingale Pledge, acknowledged as the first ethical code for the medical profession, included important guidance rules for nurses.…”