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

• 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.

Nyckelord

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

MEDICINE

MEDICIN

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