Analysis of progression and survival after 10 years of a randomized prospective study comparing mitomycin-C and bacillus Calmette-Guérin in patients with high-risk bladder cancer
2007 (English)In: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 99, no 4, 817-820 p.Article in journal (Refereed) Published
Objective: To report the 10-year follow-up of a study randomizing between instillations of bacillus Calmette-Guérin (BCG) and mitomycin-C (MMC) for treating high-risk and not muscle-invasive urinary bladder cancer to assess progression, the need for more aggressive treatment and survival (cancer-specific and overall), as many of the published studies comparing different treatments for disease that is not muscle-invasive have a short follow-up.
Patients and methods: Between 1987 and 1992, 261 patients were included; they had frequently recurring Ta/T1G1–G2, T1G3 or primary Tis-dysplasia. The patients were randomized to treatment with either 40 mg of MMC or 120 mg of BCG (Danish strain 1331) given weekly for 6 weeks, then monthly up to a year and finally every third month for a further year. The 250 evaluable patients were followed using hospital files and national registers on causes of death.
Results: The median follow-up for survivors was 123 months. The disease progressed in 58 (23%) of the patients, 34 in the MMC group and 24 in the BCG group (P = 0.26). Of the 140 patients who died, 68 were in the BCG and 72 in the MMC group (log-rank P = 0.98); most (95, 68%) died from other causes.
Conclusion: Based on the follow-up of the present patients it cannot be concluded that the drugs originally administered, MMC or BCG, differed in their effect on progression, need for subsequent treatment or survival.
Place, publisher, year, edition, pages
2007. Vol. 99, no 4, 817-820 p.
Administration; Intravesical, Adult, Aged, Aged; 80 and over, Antibiotics; Antineoplastic/therapeutic use, Antineoplastic Agents/*therapeutic use, BCG Vaccine/*therapeutic use, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mitomycin/*therapeutic use, Neoplasm Recurrence; Local/prevention & control, Neoplasm Staging, Prospective Studies, Risk Factors, Survival Analysis, Treatment Outcome, Urinary Bladder Neoplasms/*drug therapy/mortality
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-15357DOI: 10.1111/j.1464-410X.2006.06706.xPubMedID: 17244282OAI: oai:DiVA.org:uu-15357DiVA: diva2:43128