MP08-09 Down-STAGING IN AUA RISK STRATIFICATION AFTER INTRAVESICAL BACILLUS CALMETTE-GUERIN THERAPY HAS FAVORABLE EFFECT ON RECURRENCE FREE SURVIVAL AFTER 2ND LINE INTRAVESICAL GEMCITABINE CHEMOTHERAPY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP08-09 Down-STAGING IN AUA RISK STRATIFICATION AFTER INTRAVESICAL BACILLUS CALMETTE-GUERIN THERAPY HAS FAVORABLE EFFECT ON RECURRENCE FREE SURVIVAL AFTER 2ND LINE INTRAVESICAL GEMCITABINE CHEMOTHERAPY Kyung Hwan Kim, Byeong Jin Kang, Gwon Kyeong Lee, Wooseop Seong, Kyoungha Jang, Ja Yoon Ku, and Hong Koo Ha Kyung Hwan KimKyung Hwan Kim More articles by this author , Byeong Jin KangByeong Jin Kang More articles by this author , Gwon Kyeong LeeGwon Kyeong Lee More articles by this author , Wooseop SeongWooseop Seong More articles by this author , Kyoungha JangKyoungha Jang More articles by this author , Ja Yoon KuJa Yoon Ku More articles by this author , and Hong Koo HaHong Koo Ha More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003223.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite intravesical bacillus Calmette-Guerin (BCG) therapy, 40% of non-muscle invasive bladder cancer (NMIBC) patients experience tumor recurrence within 2 years. Subsequent intravesical chemotherapy is an alternative option. We evaluated the effect of down-staging in American Urological Association (AUA) risk stratification after intravesical BCG therapy on recurrence free survival (RFS) after 2nd line intravesical gemcitabine chemotherapy. METHODS: Out of 78 patients who received intravesical gemcitabine therapy from 2019 to 2022, 50 patients who received intravesical BCG (1st line) and gemcitabine (2nd line) therapy were identified. We determined the AUA risk group at the initial diagnosis of NMIBC and after the surgical treatment for tumor recurrence despite intravesical BCG therapy. The risk group migration after intravesical BCG therapy were analyzed. Kaplan-Meier analysis was performed to estimate RFS after intravesical gemcitabine therapy. RESULTS: Median number of intravesical BCG and gemcitabine therapy were 9 and 10, respectively. At initial diagnosis, 5 (10.0%), 12 (24.0%) and 33 (66.0%) cases were classified as low, intermediate and high risk group, respectively. After intravesical BCG therapy, 11 of up-staging and 8 of down-staging events occurred leading to 7 (14.0%), 6 (12.0%) and 37 (74.0%) patients stratified as low, intermediate and high risk group, respectively. RFS rate after 2nd line intravesical gemcitabine was significantly higher in the down-staging cases than the other cases (Log rank p=0.039). Median time to recurrence in the down-staging group and the other group were not reached and 13 months, respectively. CONCLUSIONS: Recurrence free survival rate after 2nd line intravesical gemcitabine therapy was higher in the patients who experienced risk group down-staging after 1st line intravesical BCG therapy. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e96 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kyung Hwan Kim More articles by this author Byeong Jin Kang More articles by this author Gwon Kyeong Lee More articles by this author Wooseop Seong More articles by this author Kyoungha Jang More articles by this author Ja Yoon Ku More articles by this author Hong Koo Ha More articles by this author Expand All Advertisement PDF downloadLoading ...