Long-term monitoring of 486P 3/12 antigen pattern (quantitative immunocytology) before, during, and after mitomycin C prophylaxis in patients with superficial bladder cancer.

Abstract Objectives. Quantitative pattern of 486p 3/12 antigenicity in urine cytologies (Quic) of patients with superficial bladder carcinoma during operation and chemoprophylaxis was evaluated to determine the duration of prophylaxis on an individual patient-oriented basis. Methods. Thirty-six patients with superficial bladder carcinoma during chemoprophylaxis (43 [range, 3 to 90] weeks to mitomycin C) have been evaluated monthly for 99 (range, 36 to 141) weeks. Results. Only 6 of 36 patients (16.7%) had tumor recurrence after mean follow-up of 67.5 weeks. During mitomycin instillations, only 5 patients converted from positive to repeated negative Quic. None of them developed tumor. Thirty-one did not convert and only 6 of them developed recurrent tumor. Conclusions. Quic seems not to be a reliable marker during mitomycin prophylaxis. After mitomycin prophylaxis, a repeated positive Quic, however, was associated with a high risk of recurrence occurring in 3 of 8 Quic-positive patients. A repeated negative or alternating Quic identified a lower risk group, showing 3 recurrent tumors in 28 patients only. We conclude that Quic cannot be used during, but after, prophylaxis to identify risk patients requiring further treatment. During prophylaixs, its value is limited to a subgroup of patients developing negative Quic, for whom prophylaxis can be stopped individually.