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BMC Urology
Published in: BMC Urology 1/2016

Open Access 01-12-2016 | Research article

Bacillus Calmette-Guerin therapy after the second transurethral resection significantly decreases recurrence in patients with new onset high-grade T1 bladder cancer

Authors: Keitaro Iida, Taku Naiki, Noriyasu Kawai, Toshiki Etani, Ryosuke Ando, Yosuke Ikegami, Takehiko Okamura, Hiroki Kubota, Atsushi Okada, Kenjiro Kohri, Takahiro Yasui

Published in: BMC Urology | Issue 1/2016

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Abstract

Background

The purpose of this study was to assess the efficacy of Bacillus Calmette-Guerin (BCG) therapy after a second transurethral resection (TUR) in new onset high-grade T1 bladder cancer.

Methods

From January 2008 to September 2013, 207 patients with new onset high-grade T1 bladder cancer after an initial TUR were treated at our university and at affiliated hospitals. Residual cancer rate, intravesical recurrence-free survival (RFS), and risk factors for intravesical recurrence were analyzed.

Results

Among a total of 207 patients, 42 patients were treated with BCG therapy following a second TUR (group 1), 23 were treated with second TUR alone (group 2), 72 were treated with BCG alone (group 3), and 70 were treated without a second TUR or BCG. The median patients’ age was 72.0 years, and the median follow-up period was 33.5 months. The second TUR revealed that 34 patients (52 %) had residual cancer. Between groups 1 and 2 and groups 1 and 3, the differences in RFS were statistically significant (p = 0.002 and 0.045, respectively). In addition, BCG therapy was the most significant factor to predict RFS after the second TUR. Among the 31 patients whose pathology of the second TUR was pT0, only 1 of 12 patients (8 %) in group 1 and 11 of 19 patients (58 %) in group 2 had a recurrence.

Conclusions

BCG instillation following a second TUR decreases intravesical recurrence, even if the pathology of the second TUR is pT0.
Literature
1.
Herr HW. The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol. 1999;162(1):74–6.CrossRefPubMed
2.
Divrik RT, Sahin AF, Yildirim U, Altok M, Zorlu F. Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival: a prospective randomised clinical trial. Eur Urol. 2010;58(2):185–90.CrossRefPubMed
3.
Grimm MO, Steinhoff C, Simon X, Spiegelhalder P, Ackermann R, Vogeli TA. Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study. J Urol. 2003;170(2 Pt 1):433–7.CrossRefPubMed
4.
Herr HW. Restaging transurethral resection of high risk superficial bladder cancer improves the initial response to bacillus Calmette-Guerin therapy. J Urol. 2005;174(6):2134–7.CrossRefPubMed
5.
Takaoka E, Matsui Y, Inoue T, Miyazaki J, Nakashima M, Kimura T, et al. Risk factors for intravesical recurrence in patients with high-grade T1 bladder cancer in the second TUR era. Jpn J Clin Oncol. 2013;43(4):404–9.CrossRefPubMed
6.
Schwaibold HE, Sivalingam S, May F, Hartung R. The value of a second transurethral resection for T1 bladder cancer. BJU Int. 2006;97(6):1199–201.CrossRefPubMed
7.
Clark PE, Agarwal N, Biagioli MC, Eisenberger MA, Greenberg RE, Herr HW, et al. Bladder cancer. J Natl Compr Canc Netw. 2013;11(4):446–75.PubMed
8.
Sfakianos JP, Kim PH, Hakimi AA, Herr HW. The effect of restaging transurethral resection on recurrence and progression rates in patients with nonmuscle invasive bladder cancer treated with intravesical bacillus Calmette-Guerin. J Urol. 2014;191(2):341–5.PubMedCentralCrossRefPubMed
9.
Brausi M, Collette L, Kurth K, van der Meijden AP, Oosterlinck W, Witjes JA, et al. Variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder: a combined analysis of seven EORTC studies. Eur Urol. 2002;41(5):523–31.CrossRefPubMed
10.
Sylvester RJ, van der Meijden A, Lamm DL. Intravesical bacillus Calmette-Guerin reduces the risk of progression in patients with superficial bladder cancer: a meta-analysis of the published results of randomized clinical trials. J Urol. 2002;168(5):1964–70.CrossRefPubMed
11.
DiPaola RS, Lattime EC. Bacillus Calmette-Guerin mechanism of action: the role of immunity, apoptosis, necrosis and autophagy. J Urol. 2007;178(5):1840–1.CrossRefPubMed
12.
13.
14.
Kawai K, Miyazaki J, Joraku A, Nishiyama H, Akaza H. Bacillus Calmette-Guerin (BCG) immunotherapy for bladder cancer: current understanding and perspectives on engineered BCG vaccine. Cancer Sci. 2013;104(1):22–7.CrossRefPubMed
Metadata
Title
Bacillus Calmette-Guerin therapy after the second transurethral resection significantly decreases recurrence in patients with new onset high-grade T1 bladder cancer
Authors
Keitaro Iida
Taku Naiki
Noriyasu Kawai
Toshiki Etani
Ryosuke Ando
Yosuke Ikegami
Takehiko Okamura
Hiroki Kubota
Atsushi Okada
Kenjiro Kohri
Takahiro Yasui
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2016
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-016-0126-x

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