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Chemo-prevention in superficial bladder cancer using mitomycin C: a survey of the practice patterns of British urologists.

Abstract：

OBJECTIVE:To assess the use of mitomycin C, by urologists within the UK, as a single-dose intravesical agent. Current European recommendations are to use one dose after any new tumour resection. METHODS:We assessed the current patterns of mitomycin C usage amongst British urologists, particularly with reference to one instillation after resecting a new bladder tumour, hypothesizing that British urologists would use mitomycin C in line with current guidelines. A one-page questionnaire was mailed to 527 consultant urologists in the UK enquiring about their use of mitomycin C in superficial bladder cancer. A second mailing was sent to encourage nonresponders. RESULTS:Of the 527 consultants, 320 (61%) replied, of which 313 (59%) questionnaires were evaluable. Of these 313 respondents, 299 (95%) used mitomycin C; 244 respondents (82%) advocated the use of one dose of mitomycin C after resecting a new tumour, but only 10 (4%) would use it immediately after tumour resection and 155 (64%) use it within 24 h. Most (98%) respondents favoured the use of a mitomycin C course after resecting multiple tumours or after multiple recurrences. Interestingly, 20 respondents (7%) would use mitomycin C as a first-line therapy for carcinoma in situ and a further 23 (8%) would use it for G3T1 tumours. A minority (14%) would use it after nephrectomy for upper tract transitional cell carcinoma. Almost all respondents indicated a dose of 40 mg in 40 mL of diluent. Maintenance treatment with mitomycin C was advocated by 44 (15%) of respondents, mainly for recurrent multifocal Ta/T1 tumours. The perception of the side-effects of mitomycin C was favourable, with 69% of respondents judging mitomycin C to be well tolerated with mild side-effects. CONCLUSION:Urologists adopt new ideas rapidly, as shown by the wide acceptance of the UK Medical Research Council study. The prompt use of mitomycin C needs to be reinforced, as efficacy is optimum within 6 h of resection. A few consultants persist in continuing with established practices, which have little evidence base. The publication of such survey results, with guidelines for treatment, should encourage those urologists whose practice is at variance from the norm to reflect on and change their practice.

journal_name

BJU Int

journal_title

BJU international

authors

Clarke NS,Basu S,Prescott S,Puri R

doi

10.1111/j.1464-410X.2006.05970.x

keywords:

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

716-9

issue

eissn

1464-4096

issn

1464-410X

pii

BJU5970

journal_volume

pub_type

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Chemo-prevention in superficial bladder cancer using mitomycin C: a survey of the practice patterns of British urologists.