The time interval from transurethral resection of bladder tumor (TURBT) to onset of bacillus Calmette-Guérin (BCG) induction does not affect therapeutic response, according to data presented at the 36th annual European Association of Urology congress.

BCG induction is conventionally administered after a recovery interval following TURBT to avoid complications related to systemic absorption, but timing of BCG instillation after TURBT has never formally been studied, and there exists no data to inform appropriate intervals after TURBT to administer induction BCG, said investigator Patrick Hensley, MD, of MD Anderson Cancer Center in Houston, Texas, who reported study findings.

Dr Hensley and colleagues studied 518 patients with nonmuscle-invasive bladder cancer who received adequate BCG therapy at a median 26 days from TURBT. BCG intolerance developed in 45 patients (9%) at a median 12th instillation. When time from TURBT to BCG instillation was stratified into quartiles, the investigators found no significant difference in recurrence-free survival (RFS), progression-free survival (PFS), and BCG intolerance.

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For patients in the first (6-19 days), second (20-26 days), third (27-34 days), and fourth quartile (35-188 days) of time from TURBT to BCG induction, median RFS times were 77, 111, 65, and 59 months, respectively, Dr Hensley reported. On multivariate analysis, time from TURBT to BCG induction was not a significant predictor of RFS and PFS either when analyzed by quartile or as a continuous variable.

Dr Hensley concluded that early administration in properly selected patients is safe, and delays do not affect therapeutic response.

Study findings also were published in BJU International.


Hensley PJ, Bree K, Brooks N, et al. Time interval from transurethral resection of bladder tumor to onset of BCG induction does not impact therapeutic response. Presented at: EAU 2021, held July 8-12, 2021. Abstract P0768.