Comparing Mitomycin C and Bacillus Calmette-Guérin (BCG) for Managing Non-Muscle Invasive Bladder Cancer Patients: A Comparative Evaluation | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 22, Volume 100, Issue 1, July 2025, Page 2669-2677 PDF (1.14 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.436789 | ||||
 View on SCiNiTO | ||||
| Abstract | ||||
| Background: The majority of bladder cancer cases that are initially diagnosed are non-muscle-invasive bladder cancers (NMIBCs). Recurrence and advancement are common, even though intravesical therapy and transurethral resection are common first lines of treatment. There is ongoing dispute about the best way to administer Bacillus Calmette-Guérin (BCG) and Mitomycin C (MMC), two commonly used medicines for intravesical instillation, particularly in cases involving high risk. Objective: To compare the outcomes, recurrence risk, progression rate, and tolerability of intravesical BCG versus MMC in cases with high-risk NMIBC. Patients and Methods: A randomized controlled trial was conducted from March 2021 to March 2023 across four Egyptian centers. A total of 90 cases with high-risk primary NMIBC were randomly assigned to either BCG or MMC treatment groups, with 45 cases in each. All participants underwent initial tumor resection followed by an immediate single dose of chemotherapy, then a six-week induction cycle with either BCG or MMC. Follow-up included routine cystoscopies, imaging, and laboratory monitoring over 24 months. Results: Recurrence rates were lower among BCG group (around 18%) compared to MMC (approximately 29%), although not statistically significant. Time of occurring first recurrence was significantly longer among BCG arm. Progression rates were low and comparable in both groups. However, adverse effects—both local and systemic—were notably higher with BCG therapy, including cystitis, hematuria, and general symptoms like fever and fatigue. Conclusion: The effectiveness of BCG and MMC in the management of high-risk NMIBC is comparable. It is important to carefully evaluate BCG's higher toxicity profile while choosing a treatment, even though it may more successfully delay recurrence. | ||||
| Keywords | ||||
| Mitomycin C; BCG; High-Risk Non-Muscle-Invasive Bladder Cancer | ||||
|
Statistics Article View: 185 PDF Download: 71 |
||||
