Replacement Instead of Discontinuation of Bacillus Calmette-Guérin Instillation in Non-Muscle-Invasive Bladder Cancer
Author:
Lin Po-Ting1ORCID, Hung Wei-Kang2, Chang Ying-Hsu23, Hsieh Ming-Li12, Liu Chung-Yi23ORCID, Huang Liang-Kang12, Chu Yuan-Cheng12, Kan Hung-Cheng12, Lin Po-Hung12ORCID, Yu Kai-Jie12, Chuang Cheng-Keng12, Wu Chun-Te12, Pang See-Tong12, Shao I-Hung124ORCID
Affiliation:
1. Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan 2. Department of Medicine, Chang Gung University, Taoyuan 333, Taiwan 3. Department of Urology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, New Taipei 236, Taiwan 4. Cancer Genome Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
Abstract
Background: To evaluate the efficacy of intravesical chemotherapy replacement in patients with intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC), who underwent bacillus Calmette-Guérin (BCG) instillation but discontinued due to global shortages or toxicity of BCG. Methods: This retrospective study included patients with intermediate- and high-risk NMIBC who received BCG intravesical instillation. Those who discontinued the treatment were divided into the pure BCG group and chemotherapy replacement group. Comparisons between these groups were performed. The primary endpoint was bladder recurrence-free survival (RFS). Results: A total of 480 patients were included. Baseline characteristics were similar between groups, but the total instillation times were higher in the chemotherapy replacement group than in the pure BCG group (n = 14.9 vs. 10.5). The chemotherapy replacement group had a better three-year RFS (p = 0.022). On multivariate analysis, the pure BCG group had significantly increased all-time and 3-year recurrences (hazard ratio 2.015 and 2.148) compared to the chemotherapy replacement group. Conclusions: Chemotherapy replacement has a better three-year RFS than no instillation in patients with intermediate- and high-risk NMIBC who received BCG instillation but facing treatment stoppage.
Subject
Cancer Research,Oncology
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