Mp71-10 Head-to-Head Oncological Outcomes Comparison of Mitomycin C vs Bacillus Calmette-Guerin Treatment in Intermediate-Risk Non-Muscle Invasive Bladder Cancer Patients

You have accessJournal of UrologyBladder Cancer: Non-invasive IV (MP71)1 May 2024MP71-10 HEAD-TO-HEAD ONCOLOGICAL OUTCOMES COMPARISON OF MITOMYCIN C VS BACILLUS CALMETTE-GUERIN TREATMENT IN INTERMEDIATE-RISK NON-MUSCLE INVASIVE BLADDER CANCER PATIENTS Pietro Scilipoti, Longoni Mattia, Mario De Angelis, Chiara Re, Giuseppe Basile, Alessandro Bertini, Leonardo Quarta, Giusy Burgio, Giulio Avesani, Francesco Pellegrino, Giuseppe Rosiello, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Renzo Colombo, Giorgio Gandaglia, Umberto Capitanio, Andrea Salonia, Francesco Montorsi, Alberto Briganti, and Marco Moschini Pietro ScilipotiPietro Scilipoti , Longoni MattiaLongoni Mattia , Mario De AngelisMario De Angelis , Chiara ReChiara Re , Giuseppe BasileGiuseppe Basile , Alessandro BertiniAlessandro Bertini , Leonardo QuartaLeonardo Quarta , Giusy BurgioGiusy Burgio , Giulio AvesaniGiulio Avesani , Francesco PellegrinoFrancesco Pellegrino , Giuseppe RosielloGiuseppe Rosiello , Andrea NecchiAndrea Necchi , Daniele RaggiDaniele Raggi , Roberta LucianòRoberta Lucianò , Renzo ColomboRenzo Colombo , Giorgio GandagliaGiorgio Gandaglia , Umberto CapitanioUmberto Capitanio , Andrea SaloniaAndrea Salonia , Francesco MontorsiFrancesco Montorsi , Alberto BrigantiAlberto Briganti , and Marco MoschiniMarco Moschini View All Author Informationhttps://doi.org/10.1097/01.JU.0001009548.76580.ba.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Induction followed by one year maintenance instillation of intravesical Bacillus Calmette-Guerin (BCG) is the standard treatment for intermediate-risk (IR) non-muscle invasive bladder cancer (NMIBC) patients. Limited data exist on the effectiveness of Mitomycin C (MMC) instillation in this setting. METHODS: We conducted a retrospective analysis including 238 IR-NMIBC patients according to the International Bladder Cancer Group (IBCG) criteria and 324 IR-NMIBC patients as per European Association of Urology (EAU) criteria, treated with at least one induction course of BCG or MMC. EAU IR classification includes non-low and -high risk patients, including pTa high grade patients. IBCG IR classification excludes any type of high grade tumor. Adequate treatment was defined as ≥12 maintenance instillations over a year. Kaplan-Meier analysis was used to estimate the 4-years recurrence-free survival (RFS) and progression-free survival (PFS) in both groups and curves were compared using log-rank test. Multivariable Cox-regression analysis was employed to identify predictors of recurrence among clinically relevant variables. RESULTS: After a median follow-up of 45 months, 86 EAU patients and 67 IBCG patients recurred, while 15 EAU and 9 IBCG patients progressed. Adequate BCG and MMC courses were administered to 31% and 29% of IR-IBCG and IR-EAU patients. At 4-years, patients treated with adequate MMC and BCG treatment had similar RFS (83% vs. 80%, p=0.9 in EAU and 76% vs. 73%, p=0.8 in IBCG) and PFS rates (98% vs. 93%, p=0.8 in EAU and 98% vs. 90%, p=0.2 in IBCG). Patients receiving non-adequate BCG compared to those treated with adequate MMC exhibited lower 4-year RFS (83% vs 68%, p=0.01 in both EAU and 76% vs 59%, p=0.03 in IBCG) and lower 4-year PFS rates for both EAU (98% vs 87%, p=0.02) and IBCG (98% vs 75%, p=0.01). Adequate MMC treatment reduced the risk of recurrence in both EAU (HR 0.33, CI 0.15-0.71, p=0.001) and IBCG groups (HR 0.41, CI 0.18-0.93, p=0.032) compared to non-adequate BCG. CONCLUSIONS: Adequate MMC treatment is as effective as BCG in EAU-IR and IBCG-IR NMIBC patients, reducing both recurrence and progression compared to inadequate BCG treatment. MMC is a viable alternative to BCG for IR patients both for IR-EAU and IR- IBCG patients. Download PPT Source of Funding: - © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1164 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Pietro Scilipoti More articles by this author Longoni Mattia More articles by this author Mario De Angelis More articles by this author Chiara Re More articles by this author Giuseppe Basile More articles by this author Alessandro Bertini More articles by this author Leonardo Quarta More articles by this author Giusy Burgio More articles by this author Giulio Avesani More articles by this author Francesco Pellegrino More articles by this author Giuseppe Rosiello More articles by this author Andrea Necchi More articles by this author Daniele Raggi More articles by this author Roberta Lucianò More articles by this author Renzo Colombo More articles by this author Giorgio Gandaglia More articles by this author Umberto Capitanio More articles by this author Andrea Salonia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF downloadLoading ...