Immediate intravesical mitomycin C instillations after tumour resection for superficial bladder cancer

Many large studies have confirmed that administration of chemotherapy (usually mitomycin C) into the bladder within 6 hours
of resection of a bladder tumour will halve the recurrence rate. However, the problems of ensuring timely and safe administration of chemotherapy by a trained nurse on the ward have meant that, until now, few patients could benefit from this simple step.

In our study, 177 intravesical mitomycin C instillations were performed in theatre immediately after superficial bladder tumor resection using the Mito-In delivery system: a closed, simple and rapid method of reconstituting and delivering intravesical mitomycin C. There were only two minor patient-related complications. As importantly, there were no staff-related adverse events (e.g. due to spillage) suggesting that mitomycin C in a theatre and recovery setting is safe and feasible. We believe this is the first study to show that administration of mitomycin C in theatre by the surgeon, at the end of resection. We suggest that this technique overcomes all the previous problems and is simple and safe for patients and staff.
This approach should help ensure that all patients can now receive post-operative intravesical chemotherapy on time.

Bibliographical reference:

Mostafid AH et al.: "Immediate administration of intravesical mitomycin C after tumour resection for superficial bladder cancer", 
BJU Int. 2006 Mar;97(3):509-12

Hugh Mostafid

Department of Urology, North Hampshire Hospital, Basingstoke, Hants, UK