Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia
IntroductionInduction intravesical Bacillus Calmette-Guerin (BCG) followed by maintenance after transurethral resection of bladder tumor, is the standard adjuvant therapy for high-risk non-muscle invasive bladder cancer (NMIBC). There is sparse evidence on the practice of intravesical BCG in Austral...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Urology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fruro.2024.1309532/full |
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| author | Chamodi Pillippu Hewa Stephen Della-Fiorentina Stephen Della-Fiorentina Stephen Della-Fiorentina Kayvan Haghighi Kayvan Haghighi Wei Chua Wei Chua Wei Chua Peey-Sei Kok Peey-Sei Kok |
| author_facet | Chamodi Pillippu Hewa Stephen Della-Fiorentina Stephen Della-Fiorentina Stephen Della-Fiorentina Kayvan Haghighi Kayvan Haghighi Wei Chua Wei Chua Wei Chua Peey-Sei Kok Peey-Sei Kok |
| author_sort | Chamodi Pillippu Hewa |
| collection | DOAJ |
| description | IntroductionInduction intravesical Bacillus Calmette-Guerin (BCG) followed by maintenance after transurethral resection of bladder tumor, is the standard adjuvant therapy for high-risk non-muscle invasive bladder cancer (NMIBC). There is sparse evidence on the practice of intravesical BCG in Australia. Our aim was to determine the outcomes of intravesical BCG therapy in NMIBC in Southwestern Sydney.MethodsThis was a multi-center retrospective audit of NMIBC patients who received intravesical BCG between January 2008 and June 2020. Data was collected across six tertiary hospitals in South Western Sydney. Primary outcome was disease-free survival (DFS). Secondary outcomes were overall survival (OS), BCG induction and maintenance rates.ResultsOf the 200 eligible patients over 12.5 years, median age was 77 years and 83% were male. Of these, 55%, 4.5%, 35% and 5% were Tis, Ta, T1 and unknown stage, respectively. All patients received induction BCG and 56% received maintenance BCG (range 3-36 months). Completion rate of induction BCG was 91%. Only 9% ceased treatment due to intolerance. The median duration of cystoscopy follow-up was 17 months. After a median follow-up time of 37 months, 55% developed recurrence (29% non-muscle invasive, 32% muscle-invasive disease, 8% distant metastasis). The 1-year and 5-year DFS rates were 72% and 41% (median DFS: 39 months). The 1-year and 5-year OS rates were 98% and 87% (median OS: not reached).ConclusionThe DFS and OS rates were comparable to previous literature. This provides real-world data to assist future clinical trials in NMIBC. |
| first_indexed | 2024-03-08T02:02:49Z |
| format | Article |
| id | doaj.art-8027e095e2df4e01a85a75371ae7e026 |
| institution | Directory Open Access Journal |
| issn | 2673-9828 |
| language | English |
| last_indexed | 2025-03-21T00:22:32Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Urology |
| spelling | doaj.art-8027e095e2df4e01a85a75371ae7e0262024-08-03T07:47:08ZengFrontiers Media S.A.Frontiers in Urology2673-98282024-02-01410.3389/fruro.2024.13095321309532Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in AustraliaChamodi Pillippu Hewa0Stephen Della-Fiorentina1Stephen Della-Fiorentina2Stephen Della-Fiorentina3Kayvan Haghighi4Kayvan Haghighi5Wei Chua6Wei Chua7Wei Chua8Peey-Sei Kok9Peey-Sei Kok10School of Medicine, Western Sydney University, Sydney, NSW, AustraliaSchool of Medicine, Western Sydney University, Sydney, NSW, AustraliaMedical Oncology, Southern Highlands Cancer Centre, Bowral, NSW, AustraliaMacarthur Cancer Therapy Clinic, Campbelltown Hospital, Sydney, NSW, AustraliaMacarthur Urology, Campbelltown Private Hospital, Sydney, NSW, AustraliaDepartment of Urology, Campbelltown Hospital, Sydney, NSW, AustraliaSchool of Medicine, Western Sydney University, Sydney, NSW, AustraliaLiverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, AustraliaSchool of Medicine, University of New South Wales, Sydney, NSW, AustraliaSchool of Medicine, Western Sydney University, Sydney, NSW, AustraliaNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, NSW, AustraliaIntroductionInduction intravesical Bacillus Calmette-Guerin (BCG) followed by maintenance after transurethral resection of bladder tumor, is the standard adjuvant therapy for high-risk non-muscle invasive bladder cancer (NMIBC). There is sparse evidence on the practice of intravesical BCG in Australia. Our aim was to determine the outcomes of intravesical BCG therapy in NMIBC in Southwestern Sydney.MethodsThis was a multi-center retrospective audit of NMIBC patients who received intravesical BCG between January 2008 and June 2020. Data was collected across six tertiary hospitals in South Western Sydney. Primary outcome was disease-free survival (DFS). Secondary outcomes were overall survival (OS), BCG induction and maintenance rates.ResultsOf the 200 eligible patients over 12.5 years, median age was 77 years and 83% were male. Of these, 55%, 4.5%, 35% and 5% were Tis, Ta, T1 and unknown stage, respectively. All patients received induction BCG and 56% received maintenance BCG (range 3-36 months). Completion rate of induction BCG was 91%. Only 9% ceased treatment due to intolerance. The median duration of cystoscopy follow-up was 17 months. After a median follow-up time of 37 months, 55% developed recurrence (29% non-muscle invasive, 32% muscle-invasive disease, 8% distant metastasis). The 1-year and 5-year DFS rates were 72% and 41% (median DFS: 39 months). The 1-year and 5-year OS rates were 98% and 87% (median OS: not reached).ConclusionThe DFS and OS rates were comparable to previous literature. This provides real-world data to assist future clinical trials in NMIBC.https://www.frontiersin.org/articles/10.3389/fruro.2024.1309532/fullintravesical BCGNMIBCdisease-free survivalbladder cancerTURBToverall survival |
| spellingShingle | Chamodi Pillippu Hewa Stephen Della-Fiorentina Stephen Della-Fiorentina Stephen Della-Fiorentina Kayvan Haghighi Kayvan Haghighi Wei Chua Wei Chua Wei Chua Peey-Sei Kok Peey-Sei Kok Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia Frontiers in Urology intravesical BCG NMIBC disease-free survival bladder cancer TURBT overall survival |
| title | Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia |
| title_full | Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia |
| title_fullStr | Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia |
| title_full_unstemmed | Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia |
| title_short | Outcomes of intravesical Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer: a retrospective study in Australia |
| title_sort | outcomes of intravesical bacillus calmette guerin in patients with non muscle invasive bladder cancer a retrospective study in australia |
| topic | intravesical BCG NMIBC disease-free survival bladder cancer TURBT overall survival |
| url | https://www.frontiersin.org/articles/10.3389/fruro.2024.1309532/full |
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