Mitomycin C instillation following ureterorenoscopic laser ablation of upper urinary tract carcinoma

Omar M. Aboumarzouk, Bhaskar Somani, Sarfraz Ahmad, Ghulam Nabi, Nicholas Townell, Slawomir G. Kata

    Research output: Contribution to journalArticle

    20 Citations (Scopus)

    Abstract

    Introduction: Instillation of Mitomycin C (MMC) should prevent implantation of cancer cells released during endoscopic treatment and prevent recurrences as seen in carcinoma of the bladder. Aim: To develop and evaluate a protocol for a single dose MMC instillation following Holmium: YAG laser ablation of upper urinary tract transitional cell carcinoma (UUT-TCC). Setting and Design: A single institute prospective study. Materials and Methods: MMC instillations protocol was designed and offered to patients between August 2005 and April 2011. Following tumor ablation, MMC was instilled into upper urinary tract (UUT) over 40 minutes. All the patients were regularly followed up. Results: Twenty UUT units (19 patients) were managed for UUT-TCCs using our MMC protocol. Two UUT units had G1pTa tumors, 14 had G2pTa, 2 had G3pTa, and 2 had G3pT1. At a mean follow-up of 24 months (range 1-72 months), 13/20 (65%) of the UUT units remained cancer-free, 3 (15%) UUT units developed stricture and were treated with endoscopic dilatation, only 1 (5%) of these developed long-term complications. None of the patients developed postoperative renal impairment or systemic side-effects. Conclusions: Using a set standard protocol, MMC can safely be instilled into the UUT after TCC ablation with minimal complications or side effects, good preservation of renal function, and with a low recurrences rate comparable to the literature.
    Original languageEnglish
    Pages (from-to)184-189
    Number of pages6
    JournalUrology Annals
    Volume5
    Issue number3
    DOIs
    Publication statusPublished - Jul 2013

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    Laser Therapy
    Mitomycin
    Urinary Tract
    Carcinoma
    Neoplasms
    Kidney
    Recurrence
    Transitional Cell Carcinoma
    Solid-State Lasers
    Dilatation
    Pathologic Constriction
    Urinary Bladder
    Prospective Studies

    Cite this

    Aboumarzouk, Omar M. ; Somani, Bhaskar ; Ahmad, Sarfraz ; Nabi, Ghulam ; Townell, Nicholas ; Kata, Slawomir G. / Mitomycin C instillation following ureterorenoscopic laser ablation of upper urinary tract carcinoma. In: Urology Annals. 2013 ; Vol. 5, No. 3. pp. 184-189.
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    abstract = "Introduction: Instillation of Mitomycin C (MMC) should prevent implantation of cancer cells released during endoscopic treatment and prevent recurrences as seen in carcinoma of the bladder. Aim: To develop and evaluate a protocol for a single dose MMC instillation following Holmium: YAG laser ablation of upper urinary tract transitional cell carcinoma (UUT-TCC). Setting and Design: A single institute prospective study. Materials and Methods: MMC instillations protocol was designed and offered to patients between August 2005 and April 2011. Following tumor ablation, MMC was instilled into upper urinary tract (UUT) over 40 minutes. All the patients were regularly followed up. Results: Twenty UUT units (19 patients) were managed for UUT-TCCs using our MMC protocol. Two UUT units had G1pTa tumors, 14 had G2pTa, 2 had G3pTa, and 2 had G3pT1. At a mean follow-up of 24 months (range 1-72 months), 13/20 (65{\%}) of the UUT units remained cancer-free, 3 (15{\%}) UUT units developed stricture and were treated with endoscopic dilatation, only 1 (5{\%}) of these developed long-term complications. None of the patients developed postoperative renal impairment or systemic side-effects. Conclusions: Using a set standard protocol, MMC can safely be instilled into the UUT after TCC ablation with minimal complications or side effects, good preservation of renal function, and with a low recurrences rate comparable to the literature.",
    author = "Aboumarzouk, {Omar M.} and Bhaskar Somani and Sarfraz Ahmad and Ghulam Nabi and Nicholas Townell and Kata, {Slawomir G.}",
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    Mitomycin C instillation following ureterorenoscopic laser ablation of upper urinary tract carcinoma. / Aboumarzouk, Omar M.; Somani, Bhaskar; Ahmad, Sarfraz; Nabi, Ghulam; Townell, Nicholas; Kata, Slawomir G.

    In: Urology Annals, Vol. 5, No. 3, 07.2013, p. 184-189.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Mitomycin C instillation following ureterorenoscopic laser ablation of upper urinary tract carcinoma

    AU - Aboumarzouk, Omar M.

    AU - Somani, Bhaskar

    AU - Ahmad, Sarfraz

    AU - Nabi, Ghulam

    AU - Townell, Nicholas

    AU - Kata, Slawomir G.

    PY - 2013/7

    Y1 - 2013/7

    N2 - Introduction: Instillation of Mitomycin C (MMC) should prevent implantation of cancer cells released during endoscopic treatment and prevent recurrences as seen in carcinoma of the bladder. Aim: To develop and evaluate a protocol for a single dose MMC instillation following Holmium: YAG laser ablation of upper urinary tract transitional cell carcinoma (UUT-TCC). Setting and Design: A single institute prospective study. Materials and Methods: MMC instillations protocol was designed and offered to patients between August 2005 and April 2011. Following tumor ablation, MMC was instilled into upper urinary tract (UUT) over 40 minutes. All the patients were regularly followed up. Results: Twenty UUT units (19 patients) were managed for UUT-TCCs using our MMC protocol. Two UUT units had G1pTa tumors, 14 had G2pTa, 2 had G3pTa, and 2 had G3pT1. At a mean follow-up of 24 months (range 1-72 months), 13/20 (65%) of the UUT units remained cancer-free, 3 (15%) UUT units developed stricture and were treated with endoscopic dilatation, only 1 (5%) of these developed long-term complications. None of the patients developed postoperative renal impairment or systemic side-effects. Conclusions: Using a set standard protocol, MMC can safely be instilled into the UUT after TCC ablation with minimal complications or side effects, good preservation of renal function, and with a low recurrences rate comparable to the literature.

    AB - Introduction: Instillation of Mitomycin C (MMC) should prevent implantation of cancer cells released during endoscopic treatment and prevent recurrences as seen in carcinoma of the bladder. Aim: To develop and evaluate a protocol for a single dose MMC instillation following Holmium: YAG laser ablation of upper urinary tract transitional cell carcinoma (UUT-TCC). Setting and Design: A single institute prospective study. Materials and Methods: MMC instillations protocol was designed and offered to patients between August 2005 and April 2011. Following tumor ablation, MMC was instilled into upper urinary tract (UUT) over 40 minutes. All the patients were regularly followed up. Results: Twenty UUT units (19 patients) were managed for UUT-TCCs using our MMC protocol. Two UUT units had G1pTa tumors, 14 had G2pTa, 2 had G3pTa, and 2 had G3pT1. At a mean follow-up of 24 months (range 1-72 months), 13/20 (65%) of the UUT units remained cancer-free, 3 (15%) UUT units developed stricture and were treated with endoscopic dilatation, only 1 (5%) of these developed long-term complications. None of the patients developed postoperative renal impairment or systemic side-effects. Conclusions: Using a set standard protocol, MMC can safely be instilled into the UUT after TCC ablation with minimal complications or side effects, good preservation of renal function, and with a low recurrences rate comparable to the literature.

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