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KMID : 1011820230640060554
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Investigative and Clinical Urology
2023 Volume.64 No. 6 p.554 ~ p.560
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The effect of immediate neoadjuvant electromotive instillation of mitomycin C with Bacillus Calmette?Guerin versus BCG alone in non-muscle-invasive bladder cancer: A randomized controlled trial
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Abdalla El Azab
Ahmed Abdelbary
Aly El Faqeh M. Okasha
Hatem Aboulkassem
Ashraf Saad Zaghloul
Riham Mohamed Karkeet
Ibrahim Abdelrahman
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Abstract
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Purpose : The clinical effect of neoadjuvant intravesical instillation of chemotherapy immediately before transurethral resection of bladder tumors (TURBT) has been a subject of recent research. The aim of this study was to assess the effect of immediate neoadjuvant electromotive instillation of mitomycin C before transurethral resection for patients with non-muscle-invasive urothelial bladder cancer.
Materials and Methods : Our study was a randomized clinical trial carried out on 50 patients diagnosed with non-muscle-invasive urothelial bladder cancer. Patients were classified into two groups: Group I consisted of 25 patients who received neoadjuvant electromotive drug administration of mitomycin C before TURBT and intravesical bacille Calmette?Guerin (BCG) per week for 6 weeks; Group II consisted of 25 patients who were treated with TURBT followed by intravesical BCG per week for 6 weeks alone (standard of care). Patients were followed up at 3, 6, 12, and 18 months by cystoscopy.
Results : Patients who received neoadjuvant electromotive drug administration of mitomycin C before TURBT in combination with BCG had a low recurrence rate compared with those who received BCG alone (12.0% vs. 48.0%, respectively; p=0.012) and a longer disease-free interval (88.0% vs. 52.0%, respectively; p=0.012). Four patients developed progression to muscle-invasive disease (16.0%) in the BCG alone group. However, this difference was not statistically significant (p=0.516). Regarding adverse effects, there were no statistically significant differences between the groups.
Conclusions : Neoadjuvant intravesical electromotive drug administration of mitomycin C before TURBT is safe; reduces recurrence rates and enhances the disease-free interval compared with TURBT followed by BCG alone.
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KEYWORD
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Electrochemotherapy, Mitomycin, Non-muscle-invasive bladder cancer, Recurrence, Transurethral resection of bladder
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