TITLE:
Completion of Maintenance Bacillus Calmette-Guerin Therapy Might Prolong Recurrence-Free Survival in Patients with Non Muscle Invasive Bladder Cancer
AUTHORS:
Zaher Bahouth, Ismail Masarwa, Ofer Nativ, Sarel Halachmi
KEYWORDS:
Bladder Cancer, BCG, Induction Therapy, Maintenance Treatment
JOURNAL NAME:
Open Journal of Urology,
Vol.5 No.6,
June
5,
2015
ABSTRACT: Objective: The aim of our study was to
compare recurrence-free survival between patients who completed treatment with
maintenance Bacillus Calmette-Guerin (BCG) and patients who did not complete
the planned treatment. Materials and Methods: Data on 115 patients with
intermediate- and high-risk Non-Muscle Invasive Bladder Cancer (NMIBC) who were
treated with BCG were available for analysis. Patients were categorized into 4
groups based on treatment duration: patients who completed three years of
maintenance treatment, patients who stopped treatment while on maintenance, patients
who were still on-treatment and patients who were treated with induction course
only. Results: Of 115 patients, 86 were men and 29 were women with mean age of
67.8 (range 40 - 93) years. 51% had high-grade tumors and 49% had low-grade
tumors. Seventy-three patients (63%) had multiple tumors. Thirty patients
(26%) were treated with induction-only, 18 patients (16%) are on-treatment, 14
patients (12%) finished maintenance protocol and 53 patients (46%) discontinued
treatment. Reasons for stopping treatment were disease recurrence in 13
patients and toxicity in 40 patients. 5-year recurrence-free survival was 100%,
63%, 60% and 56% in patients who completed maintenance treatment, stopped
during maintenance treatment, were on-treatment and those who received
induction only therapy, respectively. Conclusions: Patients should be
encouraged to adhere to maintenance BCG treatment because of its favorable
effect on recurrence-free survival probability.