MP56-10 BACILLUS CALMETTE-GUERIN INTRAVESICAL INSTILLATION THERAPY AFTER THE SECOND TRANSURETHRAL RESECTION SIGNIFICANTLY DECREASES INTRAVESICAL RECURRENCE IN PATIENTS WITH NEW-ONSET HIGH-GRADE T1 BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 2014MP56-10 BACILLUS CALMETTE-GUERIN INTRAVESICAL INSTILLATION THERAPY AFTER THE SECOND TRANSURETHRAL RESECTION SIGNIFICANTLY DECREASES INTRAVESICAL RECURRENCE IN PATIENTS WITH NEW-ONSET HIGH-GRADE T1 BLADDER CANCER Keitaro Iida, Toshiki Etani, Taku Naiki, Ryosuke Ando, Noriyasu Kawai, Keiichi Tozawa, and Kenjiro Kohri Keitaro IidaKeitaro Iida More articles by this author , Toshiki EtaniToshiki Etani More articles by this author , Taku NaikiTaku Naiki More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Noriyasu KawaiNoriyasu Kawai More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , and Kenjiro KohriKenjiro Kohri More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1578AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives High-grade T1 bladder cancer often results in intravesical recurrence. Bacillus Calmette-Guerin intravesical instillation therapy (BCG) after initial transurethral resection (TUR) helps prevent recurrence. Further, a second TUR is recommended to resect residual cancer. Here, we discuss the efficacy of BCG after the second TUR against new-onset high-grade T1 bladder cancer. Methods Our retrospective analysis included 157 patients with high-grade T1 bladder cancer based on an initial TUR, treated at our university and affiliated hospitals from January 2008 to December 2012. Of the 157 patients, 38 were treated with BCG after a second TUR (group 1) and 56 were only treated with BCG (group 2). Residual cancer and recurrence-free survival rates were statistically analyzed. Results The mean patient age was 69 years (range, 39-86 years), and the mean follow-up period was 25.7 months. The 2 groups did not differ in age, gender, and previous upper urinary tract cancer history. The 2 groups also did not differ in tumor size, tumor multiplicity, and concomitant carcinoma in situ based on initial TUR findings. In group 1, the second TUR revealed that 27 patients (71%) had residual cancer. Pathology of the second TUR specimen revealed pT0 in 8 patients (21%), dysplasia in 2 (5%), an atypical gland in 1 (3%), pTis/a in 9 (24%), and pT1 in 18 (47%). Two-year recurrence-free survival was 85% and 57% in groups 1 and 2, respectively, and 5-year recurrence-free survival was 85% and 46% in groups 1 and 2, respectively. The differences between these survival rates were statistically significant (p = 0.0016). Notably, recurrence within 6 months after the initial TUR occurred in 1 patient (3%) in group 1 and in 14 patients (25%) in group 2. Conclusions A high recurrence-free survival rate was achieved by BCG administration after the second TUR in patients with new-onset high-grade T1 bladder cancer. BCG alone is thought to have limited efficacy against residual cancer. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e567 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Keitaro Iida More articles by this author Toshiki Etani More articles by this author Taku Naiki More articles by this author Ryosuke Ando More articles by this author Noriyasu Kawai More articles by this author Keiichi Tozawa More articles by this author Kenjiro Kohri More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...