Masato Baba1,2, Susumu Kageyama3, Tetsuya Yoshida1, Ryo Fujiwara4, Chul Jang Kim4, Keita Takimoto2, Masayuki Nagasawa5, Hiroki Soga5, Yukihiro Nagatani6, Zenkai Nishikawa7, Akihiro Kawauchi1. 1. Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. 2. Department of Urology, Saiseikai Shigaken Hospital, Ritto, Japan. 3. Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. kageyama@belle.shiga-med.ac.jp. 4. Department of Urology, Kohka Public Hospital, Koka, Japan. 5. Department of Urology, Toyosato Hospital, Toyosato, Japan. 6. Department of Urology, Hikone Municipal Hospital, Hikone, Japan. 7. Department of Urology, Hino Memorial Hospital, Hino, Japan.
Abstract
BACKGROUND: To evaluate the effect of intravesical bacillus Calmette-Guerin (BCG) instillation therapy after second transurethral resection (TUR) on primary T1 bladder cancer. METHODS: The subjects were 180 patients diagnosed with T1 bladder cancer at our university and at affiliated hospitals between January 1990 and December 2015. Tumor residual rate, intravesical recurrence rate, and risk factors for intravesical recurrence were investigated. RESULTS: The median follow-up period was 26 (1-175) months. Of the 180 patients, 78 (43%) underwent a second TUR. Residual tumors were detected in 42 patients (53.8%), and no up-staging cases were observed. Within the whole group, 42 patients were treated with intravesical BCG therapy following a second TUR (group 1), 36 were treated with second TUR alone (group 2), 28 were treated with intravesical BCG therapy alone (group 3), and 74 were treated without second TUR or intravesical BCG therapy (group 4). The 1- and 5-year recurrence-free survival rates of the four groups were 80.7 and 59.7% (group 1), 69.0 and 26.3% (group 2), 76.3 and 56.6% (group 3), 64.6 and 48.6% (group 4), respectively. There was no significant difference between group 1 and group 3 (p = 0.401). Intravesical BCG therapy was the only factor preventing intravesical recurrence (p = 0.013). CONCLUSIONS: Intravesical BCG therapy alone showed a significant preventive effect with regard to intravesical recurrence. In our cohort, however, second TUR did not improve recurrence-free survival in those individuals who underwent BCG instillation.
BACKGROUND: To evaluate the effect of intravesical bacillus Calmette-Guerin (BCG) instillation therapy after second transurethral resection (TUR) on primary T1 bladder cancer. METHODS: The subjects were 180 patients diagnosed with T1 bladder cancer at our university and at affiliated hospitals between January 1990 and December 2015. Tumor residual rate, intravesical recurrence rate, and risk factors for intravesical recurrence were investigated. RESULTS: The median follow-up period was 26 (1-175) months. Of the 180 patients, 78 (43%) underwent a second TUR. Residual tumors were detected in 42 patients (53.8%), and no up-staging cases were observed. Within the whole group, 42 patients were treated with intravesical BCG therapy following a second TUR (group 1), 36 were treated with second TUR alone (group 2), 28 were treated with intravesical BCG therapy alone (group 3), and 74 were treated without second TUR or intravesical BCG therapy (group 4). The 1- and 5-year recurrence-free survival rates of the four groups were 80.7 and 59.7% (group 1), 69.0 and 26.3% (group 2), 76.3 and 56.6% (group 3), 64.6 and 48.6% (group 4), respectively. There was no significant difference between group 1 and group 3 (p = 0.401). Intravesical BCG therapy was the only factor preventing intravesical recurrence (p = 0.013). CONCLUSIONS: Intravesical BCG therapy alone showed a significant preventive effect with regard to intravesical recurrence. In our cohort, however, second TUR did not improve recurrence-free survival in those individuals who underwent BCG instillation.
Entities:
Keywords:
BCG instillation; Intravesical immunotherapy; Second TUR
Authors: Marko Babjuk; Andreas Böhle; Maximilian Burger; Otakar Capoun; Daniel Cohen; Eva M Compérat; Virginia Hernández; Eero Kaasinen; Joan Palou; Morgan Rouprêt; Bas W G van Rhijn; Shahrokh F Shariat; Viktor Soukup; Richard J Sylvester; Richard Zigeuner Journal: Eur Urol Date: 2016-06-17 Impact factor: 20.096
Authors: Peter E Clark; Neeraj Agarwal; Matthew C Biagioli; Mario A Eisenberger; Richard E Greenberg; Harry W Herr; Brant A Inman; Deborah A Kuban; Timothy M Kuzel; Subodh M Lele; Jeff Michalski; Lance C Pagliaro; Sumanta K Pal; Anthony Patterson; Elizabeth R Plimack; Kamal S Pohar; Michael P Porter; Jerome P Richie; Wade J Sexton; William U Shipley; Eric J Small; Philippe E Spiess; Donald L Trump; Geoffrey Wile; Timothy G Wilson; Mary Dwyer; Maria Ho Journal: J Natl Compr Canc Netw Date: 2013-04-01 Impact factor: 11.908