BACKGROUND: Bacillus Calmette-Guérin (BCG) is the standard intravesical treatment of high-risk noninvasive (Ta, T1, Tis) bladder cancer. Maintenance BCG is recommended for maximum efficacy. OBJECTIVE: We compared our results in a large cohort of high-risk bladder cancer patients who received BCG without maintenance with published results from randomized maintenance BCG trials. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 1021 patients underwent restaging transurethral resection for high-risk (Ta, T1, Tis) bladder cancer. INTERVENTION: Patients received a 6-wk induction course of BCG therapy. Responding patients did not receive maintenance BCG. Relapsing patients were eligible for retreatment with BCG. All patients were followed for a minimum of 5 yr. MEASUREMENTS: End points were 5-yr tumor- and progression-free survival rates. RESULTS AND LIMITATIONS: Of 816 complete responders to induction BCG, 2- and 5-yr recurrence-free survival rates were 73% and 46%, respectively. The progression-free survival rate was 89%. Progression-free survival time was 56 mo (95% confidence interval, 55-58 mo). Thirty-two percent of the patients required another course of BCG therapy. We cannot exclude that maintenance BCG may benefit patients beyond 5 yr over induction BCG alone and selective BCG retreatments. CONCLUSIONS: Our results with BCG treatment without maintenance of patients with high-risk non-muscle-invasive bladder cancer compare favorably with trials in which comparable patients received maintenance BCG.
BACKGROUND: Bacillus Calmette-Guérin (BCG) is the standard intravesical treatment of high-risk noninvasive (Ta, T1, Tis) bladder cancer. Maintenance BCG is recommended for maximum efficacy. OBJECTIVE: We compared our results in a large cohort of high-risk bladder cancerpatients who received BCG without maintenance with published results from randomized maintenance BCG trials. DESIGN, SETTING, AND PARTICIPANTS: A cohort of 1021 patients underwent restaging transurethral resection for high-risk (Ta, T1, Tis) bladder cancer. INTERVENTION: Patients received a 6-wk induction course of BCG therapy. Responding patients did not receive maintenance BCG. Relapsing patients were eligible for retreatment with BCG. All patients were followed for a minimum of 5 yr. MEASUREMENTS: End points were 5-yr tumor- and progression-free survival rates. RESULTS AND LIMITATIONS: Of 816 complete responders to induction BCG, 2- and 5-yr recurrence-free survival rates were 73% and 46%, respectively. The progression-free survival rate was 89%. Progression-free survival time was 56 mo (95% confidence interval, 55-58 mo). Thirty-two percent of the patients required another course of BCG therapy. We cannot exclude that maintenance BCG may benefit patients beyond 5 yr over induction BCG alone and selective BCG retreatments. CONCLUSIONS: Our results with BCG treatment without maintenance of patients with high-risk non-muscle-invasive bladder cancer compare favorably with trials in which comparable patients received maintenance BCG.
Authors: Massimiliano Spaliviero; Guido Dalbagni; Bernard H Bochner; Bing Ying Poon; Hongying Huang; Hikmat A Al-Ahmadie; Timothy F Donahue; Jennifer M Taylor; Joshua J Meeks; Daniel D Sjoberg; S Machele Donat; Victor E Reuter; Harry W Herr Journal: J Urol Date: 2014-03-03 Impact factor: 7.450
Authors: Julia Elsäßer; Martin W Janssen; Frank Becker; Henrik Suttmann; Kai Schmitt; Urban Sester; Michael Stöckle; Martina Sester Journal: PLoS One Date: 2013-09-11 Impact factor: 3.240
Authors: Harry Herr; Emily A Vertosick; Guido Dalbagni; Eugene K Cha; Robert Smith; Nicole Benfante; Daniel D Sjoberg; John P Sfakianos Journal: Urology Date: 2021-07-15 Impact factor: 2.633