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Discontinuance of bacille Calmette-Guerin instillation therapy for nonmuscle-invasive bladder cancer has negative effect on tumor recurrence
Urology, 07/02/09

Takeda T et al. - In a study to investigate whether occurrence of side effects or discontinuance of bacille Calmette-Guérin (BCG) therapy because of side effects is associated with its therapeutic efficacy, it was concluded that discontinuation of BCG therapy has a significantly deleterious effect on reducing the incidence of tumor recurrence. When major side effects occur, it might be preferable to attempt to mitigate major side effects to maintain BCG therapy on schedule.

Methods

Data were analyzed from 145 pts who had had nonmuscle-invasive bladder cancer (Stage pTa, pT1, or pTis) and had undergone an initial course of adjuvant BCG therapy after transurethral resection of bladder tumor.
Side effects were classified as minor and major, and the association between occurrence of side effects or discontinuance of BCG therapy because of side effects and tumor recurrence or progression was analyzed.

Results

Side effects occurred in 106 pts (73.1%) during BCG instillation.
38 of 106 pts had major side effects and 95 had minor; 27 pts had both.
BCG therapy was discontinued in 19 pts (13.1%) because of severe hematuria in 2, high fever in 8, and severe lower urinary tract symptoms in 9.
Multivariate analyses demonstrated that discontinuance of BCG therapy was an independent predictor for tumor recurrence, in addition to multiplicity.
Occurrence of side effects was not an independent predictor for tumor recurrence.
Neither discontinuance of BCG therapy nor occurrence of side effects was an independent predictor for tumor progression.

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