MP82-18 INTRAVESICAL BCG INSTILLATION IS STRONGLY ASSOCIATED WITH A DECREASED RISK OF UPPER TRACT UROTHELIAL CARCINOMA RECURRENCE AS WELL AS INTRAVESICAL RECURRENCE IN ELDERLY MALE PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP82)1 Apr 2020MP82-18 INTRAVESICAL BCG INSTILLATION IS STRONGLY ASSOCIATED WITH A DECREASED RISK OF UPPER TRACT UROTHELIAL CARCINOMA RECURRENCE AS WELL AS INTRAVESICAL RECURRENCE IN ELDERLY MALE PATIENTS WITH NON-MUSCLE INVASIVE BLADDER CANCER Hiroki Ide*, Naoya Niwa, Yuto Baba, and Mototsugu Oya Hiroki Ide*Hiroki Ide* More articles by this author , Naoya NiwaNaoya Niwa More articles by this author , Yuto BabaYuto Baba More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000974.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The incidence of elderly males with VUR increases with age, likely to be due to the higher number of men with bladder outlet obstruction. Therefore, intravesical BCG instillation after transurethral resection of bladder tumor (TURBT) may effectively prevent upper tract urothelial carcinoma (UTUC) recurrence as well as bladder recurrence, particularly in elderly males. In the present study, we investigated these relationships in non-muscle invasive bladder cancer (NMIBC) patients. METHODS: Our study population comprised 1128 NMIBC patients without a history of UTUC. Tumor grade and stage were 62.0% low and 38.0% high grade; 68.4% Ta and 31.6% T1 and/or CIS. The mean follow-up period and age were 64 months and 68.2 years old, respectively. We investigated the relationships between clinicopathological factors, including BCG instillation, and UTUC development in NMIBC patients. RESULTS: During the follow-up period, recurrent bladder cancer and UTUC developed in 437 (38.7%) and 38 (3.4%) out of all NMIBC patients, among whom 548 (48.6%) received BCG instillation after surgery. Five-year bladder and UTUC recurrence rates were 33.3 (30.1% in Ta and 37.6% in T1 and/or CIS) and 1.9%, respectively, in patients treated with BCG, which were significantly lower than in those without BCG {47.7 (44.7% in Ta and 47.0% in T1 and/or CIS) and 4.7%, p=0.001 and 0.005, respectively}. A multivariate Cox regression analysis identified BCG instillation as an independent factor for bladder and UTUC recurrence in all NMIBC patients (p=0.001 and 0.001, hazard ratio=0.517 and 0.260, respectively). Furthermore, in male patients, the 5-year UTUC recurrence rate was significantly lower in patients treated with BCG (2.0%) than in those without BCG (4.3%, p=0.022), whereas no significant differences were observed in female patients. In subgroups of older male patients (≥70 years), the 5-year UTUC recurrence rate was significantly lower in patients treated with BCG (1.6%) than in those without BCG (5.9%, p=0.031). In subgroups of younger male patients (<70 years), no significant differences were noted between these two groups. CONCLUSIONS: Intravesical BCG instillation after TURBT may prevent UTUC as well as bladder recurrence, particularly in older male NMIBC patients. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1253-e1254 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroki Ide* More articles by this author Naoya Niwa More articles by this author Yuto Baba More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement PDF downloadLoading ...