BCG-refractory vs. BCG-relapsing non-muscle-invasive bladder cancer: A prospective cohort outcomes study Journal Article
| Authors: | Herr, H. W.; Milan, T. N.; Dalbagni, G. |
| Article Title: | BCG-refractory vs. BCG-relapsing non-muscle-invasive bladder cancer: A prospective cohort outcomes study |
| Abstract: | CONCLUSIONS: BCG-refractory and BCG-relapsing categories differentiate BCG-failed patients into high-and lower-risk prognostic groups that may be useful in guiding treatment strategies. PURPOSE: Patients with recurrent or persistent high-grade non-muscle-invasive bladder cancer after bacille Calmette-Guérin (BCG) therapy are termed "BCG failures." We hypothesize that BCG-refractory patients who fail to respond to BCG have worse outcomes after bladder-sparing treatments compared with BCG-relapsing patients whose tumors recur after at least a 6-month disease-free interval. MATERIALS AND METHODS: We screened 32 patients who had failed BCG therapy for eligibility in a multicenter investigational trial. BCG-refractory patients received instillations of a mycobacterial cell wall-DNA complex extract. BCG-relapsing patients were treated with additional BCG or other intravesical agents. Both groups of patients were followed prospectively with transurethral biopsy after 6 months, and cystoscopy every 3 to 6 months for more than 2 years. Median follow-up time for all patients was 53 months (range: 24-72 mo). RESULTS: Seventeen patients were classified as BCG refractory and 15 patients defined BCG relapsing. Recurrence-free median survival time was 10 months for BCG-refractory patients receiving mycobacterial cell wall-DNA complex vs. 23 months for BCG-relapsing patients who received another induction course of BCG therapy (P = 0.002). Progression-free survival time was 18 months for BCG-refractory vs. 52 months for BCG-relapsing patients (P = 0.001). Of the 17 BCG-refractory patients, 8 (47%) have died vs. 3 (20%) of the 15 BCG-relapsing patients. Copyright © 2015 Elsevier Inc. All rights reserved. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; clinical trial; disease course; disease free survival; follow up; follow-up studies; prospective study; prospective studies; bcg vaccine; neoplasm recurrence, local; pathology; bladder cancer; bladder tumor; urinary bladder neoplasms; disease progression; multicenter study; tumor recurrence; cystoscopy; muscle; muscles; very elderly; humans; human; male; female; bcg failure |
| Journal Title: | Urologic Oncology: Seminars and Original Investigations |
| Volume: | 33 |
| Issue: | 3 |
| ISSN: | 1078-1439 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2015-03-01 |
| Start Page: | 108.e1 |
| End Page: | 108.e4 |
| Language: | English |
| DOI: | 10.1016/j.urolonc.2014.02.020 |
| PUBMED: | 25813144 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 February 2016 -- Source: Scopus |
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