In Bladder Cancer Patients, Post-BCG Inflammation Is a Positive Sign

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Inflammation or granuloma in histologic samples following intravesical bacille Calmette-Guérin (BCG) treatment in patients with non-muscle-invasive bladder cancer (NMIBC) is associated with a lower risk of disease recurrence and progression, researchers reported online ahead of print in BJU International.

Samer Jallad, MD, of Royal Sussex County Hospital in Brighton, U.K., and colleagues studied 215 patients who underwent BCG treatment for NMIBC. The median follow-up was 32 months. Post-treatment biopsies revealed inflammation in 125 patients, granulomas in 60, and neither inflammation nor granuloma in 18 (normal histology group). Twelve patients did not have biopsies and were subsequently excluded from the study.

The recurrence rate was 17% (10 of 60 patients) in the granuloma group, 38% (47 of 125 patients) in the inflammation group, and 71% (10 of 14 patients) in the normal histology group.

The mean recurrence-free survival times were significantly longer in the inflammation and granuloma groups than the normal histology group (56 and 65 months, respectively, vs. 20 months). The mean progression-free survival times were significantly longer in the inflammation and granuloma groups than the normal histology group (82 and 75 months, respectively, vs. 33 months).

The absence of inflammation or granuloma was significantly associated with an increased likelihood of recurrence in multivariate analysis.

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