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目的 探讨术中应用丝裂霉素预防表浅性膀胱癌术后复发的可行性。方法 将表浅性膀胱癌 78例随机分成两组 ,A组 (38例 )患者术中粘膜下注射丝裂霉素 ,B组 (40例 )为对照组。两组术后均定期膀胱内灌注丝裂霉素 ,随访时间 3年以上 ,观察患者无瘤间期、肿瘤复发率和不良反应发生情况。结果 A组患者较B组术后 3年无瘤间期显著延长。术后 1年A组和B组分别有 2例和 6例复发 ,其复发率分别为 5 3%和 1 5 0 %。术后 3年复发率A组和B组分别为 1 8 4 %和4 0 0 %。其差异有显著性 (P <0 0 5 )。不良反应发生情况A组和B组分别为 5例 (1 3 2 %)和 7例(1 7 5 %) ,两组间无显著性差异 (P >0 0 5 )。结论 术中应用低浓度小剂量丝裂霉素粘膜下注射是一种安全、可靠的预防表浅性膀胱癌术后复发的方法。
Objective To investigate the feasibility of intraoperative mitomycin C for prevention of postoperative recurrence of superficial bladder cancer. Methods 78 cases of superficial bladder cancer were randomly divided into two groups. The patients in group A (38 cases) underwent submucosal injections of mitomycin and the group B (40 cases) served as the control group. Two groups were regularly intravesical instillation of mitomycin, follow-up time of 3 years or more, observed in patients with tumor-free interval, tumor recurrence rate and adverse reactions. Results A group of patients than in the three-year postoperative tumor-free interval was significantly longer. One year after operation, there were 2 cases in group A and 6 cases in group B, and the recurrence rates were 53% and 150% respectively. The recurrence rates at 3 years after operation were 18.4% and 40.0% in group A and group B, respectively. The difference was significant (P <0 05). Adverse reactions occurred in group A and group B were 5 cases (13.2%) and 7 cases (17.5%), no significant difference between the two groups (P> 0.05). Conclusion Intraoperative low dose and low dose of mitomycin submucosal injection is a safe and reliable method to prevent postoperative recurrence of superficial bladder cancer.