Intravesical bacillus Calmette-Guérin (BCG) following transurethral resection of bladder tumor (TURBT) is associated with a decreased risk of upper tract urothelial carcinoma and bladder cancer recurrence, new data presented at the American Urological Association 2020 Virtual Experience suggest.
Hiroki Ide, MD, of Keio University School of Medicine in Tokyo, and colleagues studied 1128 patients with nonmuscle-invasive bladder cancer (NMIBC) without a history of upper tract urothelial carcinoma (UTUC). During a mean follow-up period of 64 months, recurrent bladder cancer and UTUC developed in 437 (38.7%) and 38 (3.4%) patients, respectively. Of the 1128 patients, 548 (48.6%) received BCG instillation following TURBT. The 5-year bladder and UTUC recurrence rates were 33.3% and 1.9%, respectively, in patients treated with BCG, rates that were significantly lower than the 47.7% and 4.7% rates, respectively, among those not treated with BCG.
On multivariate analysis, BCG instillation was independently and significant associated with an approximately 48% and 74% decreased risk of bladder cancer and UTUC recurrence, respectively.
Among male patients, the 5-year UTUC recurrence rate was significantly lower among patients treated with BCG than in those not treated with BCG (2.0% vs 4.3%). The investigators observed no significant differences among female patients.
In addition, among male patients aged 70 years or older, the 5-year UTUC recurrence rate was significantly lower in patients treated with BCG than those who were not (1.6% vs 5.9%). Investigators found no significant difference among men younger than 70 years.
Of the 1128 patients, 62% and 38% had high-grade and low-grade tumors; 68.4% had Ta and 31.6% had T1 and/or carcinoma in situ.
Ide H, Niwa N, Baba Y, et al. Intravesical BCG instillation is strongly associated with a decreased risk of upper tract urothelial carcinoma recurrence as well as intravesical recurrence in elderly male patients with non-muscle invasive bladder cancer. Presented at the American Urological Association 2020 Virtual Experience held in May. Abstract MP82-18.