1741 COULD PATIENT AGE INFLUENCE TUMOR RECURRENCE RATE IN NON-MUSCLE INVASIVE BLADDER CANCER PATIENTS TREATED WITH BCG IMMUNOTHERAPY?

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 20111741 COULD PATIENT AGE INFLUENCE TUMOR RECURRENCE RATE IN NON-MUSCLE INVASIVE BLADDER CANCER PATIENTS TREATED WITH BCG IMMUNOTHERAPY? Kazuyuki Yuge, Eiji Kikuchi, Kazuhiro Matsumoto, Nobuyuki Tanaka, Toshikazu Takeda, Akira Miyajima, Ken Nakagawa, and Mototsugu Oya Kazuyuki YugeKazuyuki Yuge Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto Tokyo, Japan More articles by this author , Nobuyuki TanakaNobuyuki Tanaka Tokyo, Japan More articles by this author , Toshikazu TakedaToshikazu Takeda Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2068AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The effect of BCG therapy in elderly patients with non-muscle invasive bladder cancer (NMIBC) has not yet been fully evaluated. The aim of the present study was to evaluate whether patient age could influence the response to BCG therapy concerning the prevention of tumor recurrence and/or the side effects of BCG therapy. METHODS A total of 1252 cases treated with TUR-BT for NMIBC between 1981 and 2005 at our institution were reviewed, and 447 cases underwent BCG therapy after TUR-BT were identified in the present study. The patients were divided into 4 age categories; under 55 (N=86), 55 to 64 (N=143), 65 to 74 (N=132), and equal or older than 75 (N=86). Patient age was analyzed to determine if it affected subsequent tumor recurrence. Side effects (fever and BCG cystitis) were classified as minor or major and were analyzed. RESULTS The median follow-up period was 4.2 years. The 5 and 10-year recurrence-free survival rates for each age group were 57.6% and 53.2%, 63.3% and 47.6%, 58.5% and 47.9%, and 50.6% and 35.8%, respectively. Kaplan-Meier curves of recurrence-free survival rates showed that patients aged 55 to 64 had significantly better tumor-free survival period compared to equal or older than 75 group (p=0.029). However, in multivariate analysis, the presence of prior bladder cancer (p=0.005, HR:1.572) and tumor grade 3 (p=0.030, HR:1.377) were independent risk factors for subsequent tumor recurrence. In addition, the analyses showed that the incidence of fever was significantly higher in the younger group; 9.3% in equal or older than 75 group, compared to 24.4% in the under 55 group, 18.9% in the 55–64 group, and 18.2% in the 65–74 group (p=0.0081, p=0.0511, and p=0.0702, respectively). On the contrary, the incidence of minor or major symptoms of cystitis in the under 55 group was 30.2%, which was significantly lower than that of the 55–64 group (48.3%), 65–74 group (56.1%), and equal or older than 75 group (46.5%) (p=0.0074, p=0.0002, and p=0.0282, respectively). Kaplan-Meier analysis was demonstrated to evaluate whether the presence of side effect could predict the effect of BCG therapy. However, there was no significant correlation between subsequent tumor recurrence and the presence of each side effect (fever or BCG cystitis) in any age group. CONCLUSIONS Patient age could not influence tumor recurrence in patients with bladder cancer treated with BCG therapy. Although there were no significant correlation between subsequent tumor recurrence and presence of side effects, incidence of fever and BCG cystitis were related to the patient age groups. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e699 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kazuyuki Yuge Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Kazuhiro Matsumoto Tokyo, Japan More articles by this author Nobuyuki Tanaka Tokyo, Japan More articles by this author Toshikazu Takeda Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...