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Baba M, Kageyama S, Yoshida T, Fujiwara R, Kim CJ, Takimoto K, Nagasawa M, Soga H, Nagatani Y, Nishikawa Z, Kawauchi A. Intravesical bacillus Calmette-Guerin therapy after second transurethral resection for primary T1 bladder cancer. Int J Clin Oncol 2018; 23:951-956. [PMID: 29761307 DOI: 10.1007/s10147-018-1292-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/08/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND To evaluate the effect of intravesical bacillus Calmette-Guerin (BCG) instillation therapy after second transurethral resection (TUR) on primary T1 bladder cancer. METHODS The subjects were 180 patients diagnosed with T1 bladder cancer at our university and at affiliated hospitals between January 1990 and December 2015. Tumor residual rate, intravesical recurrence rate, and risk factors for intravesical recurrence were investigated. RESULTS The median follow-up period was 26 (1-175) months. Of the 180 patients, 78 (43%) underwent a second TUR. Residual tumors were detected in 42 patients (53.8%), and no up-staging cases were observed. Within the whole group, 42 patients were treated with intravesical BCG therapy following a second TUR (group 1), 36 were treated with second TUR alone (group 2), 28 were treated with intravesical BCG therapy alone (group 3), and 74 were treated without second TUR or intravesical BCG therapy (group 4). The 1- and 5-year recurrence-free survival rates of the four groups were 80.7 and 59.7% (group 1), 69.0 and 26.3% (group 2), 76.3 and 56.6% (group 3), 64.6 and 48.6% (group 4), respectively. There was no significant difference between group 1 and group 3 (p = 0.401). Intravesical BCG therapy was the only factor preventing intravesical recurrence (p = 0.013). CONCLUSIONS Intravesical BCG therapy alone showed a significant preventive effect with regard to intravesical recurrence. In our cohort, however, second TUR did not improve recurrence-free survival in those individuals who underwent BCG instillation.
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Affiliation(s)
- Masato Baba
- Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.,Department of Urology, Saiseikai Shigaken Hospital, Ritto, Japan
| | - Susumu Kageyama
- Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
| | - Tetsuya Yoshida
- Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
| | - Ryo Fujiwara
- Department of Urology, Kohka Public Hospital, Koka, Japan
| | - Chul Jang Kim
- Department of Urology, Kohka Public Hospital, Koka, Japan
| | - Keita Takimoto
- Department of Urology, Saiseikai Shigaken Hospital, Ritto, Japan
| | | | - Hiroki Soga
- Department of Urology, Toyosato Hospital, Toyosato, Japan
| | | | | | - Akihiro Kawauchi
- Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan
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