MP15-08 HIGH GRADE NON-INVASIVE RECURRENCE FOLLOWING INDUCTION BCG FOR PT1/CIS UROTHELIAL CARCINOMA OF BLADDER, IS IT AN INDICATION FOR CYSTECTOMY?

Abstract

You have accessJournal of UrologyBladder Cancer: Non-invasive I1 Apr 2017MP15-08 HIGH GRADE NON-INVASIVE RECURRENCE FOLLOWING INDUCTION BCG FOR PT1/CIS UROTHELIAL CARCINOMA OF BLADDER, IS IT AN INDICATION FOR CYSTECTOMY? Manmeet Saluja, Daljit Kaur, Jonathan Masters, Andrew Williams, Michael Rice, and Kamran Zargar-Shoshtari Manmeet SalujaManmeet Saluja More articles by this author , Daljit KaurDaljit Kaur More articles by this author , Jonathan MastersJonathan Masters More articles by this author , Andrew WilliamsAndrew Williams More articles by this author , Michael RiceMichael Rice More articles by this author , and Kamran Zargar-ShoshtariKamran Zargar-Shoshtari More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.493AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For most patients with pT1 and Carcinoma in situ (CIS) urothelial carcinoma of the bladder (UCB), intravesical induction Bacillus Calmette Guérin (IND-BCG) is considered the gold standard treatment. However the criteria to abandon BCG therapy (i.e. BCG failure) in cases of recurrent but non-progressive UC can be vague. In this study we aim to assess a large cohort of CIS and pT1 UCB patients treated with intravesical IND-BCG and report on the outcomes according to the grade and stage of recurrences following IND-BCG. METHODS The data is from a single academic institution which is the only referral site for all BCG therapies for a large metropolitan area. Patients with initial diagnosis of pT1 and CIS received induction course of intravesical BCG. Post induction cystoscopy was carried out for all patients, and follow up was three monthly for the first two years, and at least biannually thereafter. RESULTS From 2001 to 2014, 261 patients received IND-BCG for pT1/CIS. Post BCG status were as follows: 132 (51%) pT0, 48 (18%) CIS, 31 (12%) pT1, 32 (12%) pTaHG and 10 (4%) pTaLG. Of the patients who were pT0 post-BCG, 74% remained disease free at a median of 8 mo. 19% developed high-grade recurrences including 4% with muscle invasive UC (MIUC) at a median of 16 mo (12-27) from diagnosis. Of patients with residual CIS, 60% responded to further BCG, with progression to invasive disease in 13%. Of residual pTaHG patients, 53% became pT0 and 9% eventually had cystectomy at 32.4 mo for disease progression to CIS or =pT1. 10 patients had pTa-LG recurrence and one required cystectomy. Only 36% of residual pT1 patients became pT0 with 29% developing invasive disease. 39% of pT1 compared to 17% of the CIS required cystectomy at a median of 17.5 mo (p=0.036). pT0 rates were significantly higher for CIS patients compared to pT1 (60% vs. 36%, 0.047), but similar between CIS and pTaHG. CONCLUSIONS Non-invasive recurrence of high grade UC following BCG may respond to further intravesical therapy however response is less likely in recurrent pT1 UC. Following BCG recurrent non-invasive high © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e173-e174 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Manmeet Saluja More articles by this author Daljit Kaur More articles by this author Jonathan Masters More articles by this author Andrew Williams More articles by this author Michael Rice More articles by this author Kamran Zargar-Shoshtari More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...