Upper urinary tract instillation of a single-dose of mitomycin C immediately following therapeutic ureteroscopy for upper tract urothelial carcinoma (UTUC) appears to reduce the risk of urothelial recurrence, according to investigators.
Andrea Gallioli, MD, Fundacio Puigvert in Barcelona, Spain, and colleagues studied 52 patients with UTUC treated by endoscopic ablation, of whom 26 were selected for mitomycin C instillation and 26 served as controls. The primary endpoint was urothelial recurrence-free survival (URFS) evaluated by second-look ureteroscopy and computed tomography/ureteroscopy every 6 months.
The urothelial recurrence rate was 23.5% in the mitomycin C arm compared with 55.5% in the control group, Dr Gallioli’s team reported in the Journal of Endourology. The mean URFS was 28.8 months in the mitomycin C arm compared with 18.8 months among controls.
On multivariate Cox regression, mitomycin C instillation was significantly associated with an 87% decreased risk of urothelial recurrence.
Clavien grade II or less complications developed in 32% of the mitomycin C arm and 30.7% of the control group, a nonsignificant difference between the groups, the investigators reported.
Gallioli A, Boissier R, Territo A, et al. Adjuvant single-dose upper urinary tract instillation of mitomycin C after therapeutic ureteroscopy for upper tract urothelial carcinoma: a single-centre prospective non-randomized trial [published online March 13, 2020]. J Endourol. https://doi.org/10.1089/end.2019.0750