Chemoresection With 4 Weekly Intravesical Instillations Of Mitomycin C Versus Transurethral Resection (TUR) Followed By One Single Immediate Instillation Of Mitomycin C In Single, Small, Papillary Stage Ta, T1 Bladder Tumors: A Prospective Randomized Phase III Trial

OBJECTIVES:

• Compare the efficacy of chemoresection with 4 weekly intravesical instillations of mitomycin vs transurethral resection followed by 1 instillation of mitomycin in patients with low-risk superficial transitional cell carcinoma of the bladder.
• Compare the disease-free survival of patients treated with these regimens.
• Determine the response rate at 6 weeks in patients treated with chemoresection.
• Determine the percent of patients with tumor at 6 weeks treated with transurethral resection.
• Compare the quality of life of patients treated with these regimens.
• Compare the side effects of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease status (primary vs recurrent) and participating center. Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients undergo chemoresection with intravesical instillation of mitomycin once weekly for 4 weeks.
• Arm II: Patients undergo transurethral resection followed within 1-6 hours by intravesical instillation of mitomycin.

Quality of life is assessed at baseline, at week 1 (arm II only), at week 5 (arm I only), and then at week 6.