Effectiveness of BCG in recurrent non-muscle invasive bladder tumor: A 10 year retrospective study from a tertiary care centre

Abstract

Abstract Introduction: Cancer-a term a word used to be so rare five decades back that people didn’t even know about this but now it has become so common and rampant and interestingly can be compared to a devil whose size seems to be increasing progressively. Even after so much advancement in medical science we have not been able to catch its tail. Urinary Bladder one of the very common cancer in our urological domain with its subtype non-muscle invasive bladder cancer (NMIBC) having high recurrence and progression rates has become very interesting subject for research. Such features led investigators to study the use of drugs to prevent this, out of which Bacillus Calmette–Guerin (BCG) has been successfully used as an intra vesical therapy to prevent recurrence and progression in NMIBC for more than four decades. Materials and Methods: In our study we have analyzed 111 patients retrospectively with only recurrent urinary bladder tumor irrespective of treatment received in the past. After completion Trans Urethral resection of bladder tumor (TURBT) and re-staging TURBT to substantiate the stage, induction and maintenance course of intravesical BCG was given according to Lamm protocol & the impact of this therapy was studied in regards to recurrence free, progression free, cystectomy free & overall survival rates. Result: Out of 111 patients, sixty percent of patient remained disease free, 19 patients had stage progression, nine patients underwent radical cystectomy and there was three cancer specific death. Conclusion: Despite BCG being the gold standard treatment for NMIBC, still intense research is required as there is a wide dark area of BCG failure.