COMPARATIVE STUDY OF CLINICAL SAFETY OUTCOME OF NEOADJUVANT INTRAVESICAL MITOMYCIN-C THERAPY IMMEDIATELY BEFORE TRANSURETHRAL RESECTION OF BLADDER TUMOR VS PERIOPERATIVE INTRAVESICAL MITOMYCIN-C IN PATIENTS WITH NONMUSCLE-INVASIVE BLADDER CANCER

Objective: This study aims to compare the outcome and complications of adjuvant vs neoadjuvant IMMC (intravesical mitomycin C) for non-muscle-invasive bladder cancer (NMIBC). Material & Methods: This prospective randomized observational study was conducted from June 2023 to December 2024. Sixty-two patients with clinico-radiological evidence of bladder growth were randomized into two arms: Neoadjuvant IMMC and Perioperative IMMC. Results: Immediate complications were more frequent in Group B, with significantly higher dysuria, suprapubic pain (74.2% vs 32.3%), and febrile UTIs (29% vs 3.2%). Haematuria was also more common in Group B (58.1%). Early complications showed similar trends: dysuria (51.6% vs 19.4%), haematuria (45.2% vs 19.4%), and bladder changes (23.3% vs 0%) were more prevalent in Group B. Allergic reactions were slightly lower in Group B (6.5%) than in Group A (9.7%). Conclusion: Pre-operative MMC instillation was more effective in reducing recurrence and improving resection ease, with fewer complications. Perioperative MMC was associated with increased inflammation and adverse events. Pre-TURBT MMC is recommended for improved clinical outcomes, while peri-operative MMC may be considered for select low-risk patients. Keywords: Complication, IMMC, bladder cancer.