Introduction & Objectives
1. Compare the recurrence and progression-free survival among patients treated and untreated with post-TUR chemotherapy.
2. Determine the target population with NMIBC potentially beneficiary of MMC post-TUR.
Material & Methods
Non experimental longitudinal prospective study of 349 consecutive patients with NMIBC subsidiary of MMC post-TUR in the Jerez Hospital between 2010-2013. Potential predictors of efficacy of MMC post-TUR in our series were analysed: Age, gender, smoking quit at the time of diagnosis, early recurrence.
The average rate of patients included in the program is 53.9%, an increase of 79.3% (p <0.001)
at 3 years. Mean follow-up 26.3 ± 0.7 months. Mean time to first recurrence significantly higher in the
MMC post-TUR group receiving [43.5 months (95% CI, 40.7 to 46.3) vs 38.5 months (95% CI, 35.5 to 41.6); p <0.05]. The absolute risk reduction of recurrence with MMC post-TUR is 14.5% (95% CI, 5.9 to 23.5%, p <0.001), and the number of patients needed to be treated (NNT) of 6.9 (95% CI, 4.3 to 17.9 P <0.001). The statistical analysis of the exposed cohort to MMC post-TUR (n = 164) and unexposed (n = 185) results that the MMC post-TUR is effective in reducing the risk of recurrence in tumours PTa-1, low-high grade, single-multiple, ≤ 3cm maximum diameter, with no history of bladder tumours in the 12 months prior, with a sample of muscle layer in the TUR, and without pretreatment with MMC.
MMC decreases the percentage of tumour recurrence in NMIBC, and increases disease-free time. The MMC increases disease-free time in all prognosis recurrence groups. The effectiveness of MMC post-TUR in our country is similar to that reported by other groups. Our findings suggest a potential benefit of MMC post-TUR in all patients with primary NMIBC or without early relapse, ≤ 3cm without prior treatment with intravesical MMC.