Efficacy and Safety of Intravesical Mitomycin C versus Bacillus Calmette-Guerin for Superficial Bladder Cancer: A Systematic Review

OBJECTIVE: To evaluate the efficacy and safety of intravesical mitomycin C( MMC) versus Bacillus Calmette-Guerin( BCG) for superficial bladder cancer. METHODS: The literature about randomized controlled trials( RCTs) on intravesical MMC versus BCG for superficial bladder cancer were retrieved from databases such as Pub Med,EMbase,CBM,the Cochrane Library,CNKI,VIP and Wan Fang Data( from the date of their establishment to June 30,2013). According to the inclusion and exclusion criteria,two reviewers independently screened the literature,extracted data and assessed the quality of the included studies. Meta-analysis was conducted using Rev Man5. 2 software. RESULTS: A total of 12 RCTs involving 2 602 patients were included. The results of meta-analysis showed that there were no statistically significant differences regarding the first time recurrence rate,3-years recurrence rate,disease progression,and mortality between MMC group and BCG group [RR = 0. 99,95% CI( 0. 85,1. 14),P = 0. 86; RR = 0. 89,95% CI( 0. 71,1. 13),P = 0. 35; RR = 0. 85,95% CI( 0. 64,1. 13),P = 0. 27; RR = 1. 12,95%CI( 0. 76,1. 64),P = 0. 57]. The incidences of hematuria,fever,dysuria in MMC group was lower than in the BCG group [RR = 0. 34,95% CI( 0. 16,0. 71),P = 0. 004; RR = 0. 14,95% CI( 0. 06,0. 32),P ﹤ 0. 00001;RR = 0. 71,95% CI( 0. 58,0. 86),P = 0. 0006]. CONCLUSION: The first time recurrence rate,3-year recurrence rate,disease progression and mortality were similar between MMC group and BCG group,but MMC is safer than BCG.