You have accessJournal of UrologyBladder Cancer: Superficial1 Apr 20101356 A MULTI-INSTITUTIONAL ANALYSIS OF PATIENT OUTCOMES FOLLOWING INTRAVESICAL BACILLUS CALMETTE-GUERIN TREATMENT FOR NON-MUSCLE INVASIVE BLADDER CANCER Pippa Sangster, Andrew Symes, Roger Walker, Roland Morley, Alan Thompson, John Dick, Peter Le Roux, and Sarb Sandhu Pippa SangsterPippa Sangster London, United Kingdom More articles by this author , Andrew SymesAndrew Symes Epsom, United Kingdom More articles by this author , Roger WalkerRoger Walker Epsom, United Kingdom More articles by this author , Roland MorleyRoland Morley London, United Kingdom More articles by this author , Alan ThompsonAlan Thompson London, United Kingdom More articles by this author , John DickJohn Dick London, United Kingdom More articles by this author , Peter Le RouxPeter Le Roux Epsom, United Kingdom More articles by this author , and Sarb SandhuSarb Sandhu London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.983AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Clinical trials have established a major role for BCG immunotherapy in urological oncology. In parallel, the major principles of the immunological mechanism have been revealed. Despite this success, questions still remain regarding its clinical use, mechanism of action and potential improvement. The aim of the present study was to evaluate the recurrence of superficial bladder cancer, and to investigate the efficiency of BCG maintenance in relation to compliance with SWOG protocol METHODS 129 patients treated with initial TURBT prior to BCG maintenance were identified over a 6 year period. Pathological parameters and risk factors of recurrence were analysed. Recurrence/progression free survival were investigated in relation to the number of maintenance cycles patients underwent RESULTS Median follow up was 25 months (range 4-79). At diagnosis 91 patients (71%) had high risk disease (CIS / G3T1).64 (49%) patients are currently still on the maintenance schedule and 12 (9%) patients completed the full course. The majority of patients discontinuing BCG did so because of recurrence or progression. 25 patients (19.4%) experienced recurrence, at a median time of 10 months. On further analysis age, sex, smoking status, grade and stage had no impact on recurrence free survival. Patients undergoing either 0 or 1 maintenance BCG cycle were associated with significantly worse recurrence free survival. 23 patients (17.8%) experienced progression, at a median time of 19 months. Having 4 or more maintenance cycles was associated with significantly better progression free survival. Over the time period, there were 7 deaths (5 disease related). 7 patients underwent a cystectomy at a median time of 19 months (8-38) and 12 patients underwent radiotherapy at 19.5 months (12-33). CONCLUSIONS In our study the rate of recurrence was 19.4%, which is lower than other reported studies. Statistical analysis showed that patients receiving 4 or more cycles had significantly better progression free survival. 49% patients were still ongoing in their maintenance cycles(majority patients ≥3 cycles) with no sign of progression and the majority of patients who had stopped did not to do so because of toxicity, but progression. Only 16% of the SWOG trial patients received all 8 scheduled maintenance courses during the 3 years due to toxicity. Recurrence was associated with progression, and early recurrence is a poor prognostic indicator. Patients with early recurrence are at high risk of progression and should be offered alternative treatment early © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e524 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pippa Sangster London, United Kingdom More articles by this author Andrew Symes Epsom, United Kingdom More articles by this author Roger Walker Epsom, United Kingdom More articles by this author Roland Morley London, United Kingdom More articles by this author Alan Thompson London, United Kingdom More articles by this author John Dick London, United Kingdom More articles by this author Peter Le Roux Epsom, United Kingdom More articles by this author Sarb Sandhu London, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...