Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer

Authors

  • Rahmi Gokhan Ekin Tepecik Teaching and Research Hospital, Department of Urology
  • Ilker Akarken Kemalpasa State Hospital, Urology Clinic
  • Ferruh Zorlu Tepecik Teaching and Research Hospital, Department of Urology
  • Huseyin Tarhan Tepecik Teaching and Research Hospital, Department of Urology
  • Ulku Kucuk Associate Professor, Tepecik Teaching and Research Hospital, Department of Pathology
  • Zubeyde Yildirim Ekin Tepecik Teaching and Research Hospital, Department of Pathology
  • Rauf Taner Divrik Sifa University, Faculty of Medicine, Department of Urology

DOI:

https://doi.org/10.5489/cuaj.2708

Keywords:

Hyperthermia, Chemohyperthermia, Bladder Cancer, Bacillus Calmette-Guerin, BCG

Abstract

Introduction: Patients with high-risk non-muscle invasive bladder cancer (NMIBC) need adjuvant intravesical treatment after surgery. Although bacillus Calmette-Guérin (BCG) is highly effective, new adjuvant treatments to decrease recurrences and toxicity have been studies. We performed a retrospective propensity score-matched study to compare the efficacy of BCG and chemohyperthermia (C-HT).

Methods: We included 1937 patients diagnosed with bladder cancer between January 2004 and January 2014. The primary efficacy endpoint was recurrence-free interval. Patients treated with C-HT were matched with patients treated with BCG using propensity score- matched analysis. Cox-regression models were used to estimate the association between intravesical treatments and the presence of recurrence and progression.

Results: Of the 710 patients treated with intravesical treatments, 40 and 142 were eligible for inclusion in C-HT and BCG groups, respectively. Following case matching, there were no differences in patient or tumour characteristics between treatment groups. The 2-year recurrence-free interval in C-HT and BCG groups were 76.2% and 93.9%, respectively (p = 0.020). C-HT treatment (hazard ratio [HR] 5.42; 95% confidence interval [CI] 1.11–26.43; p = 0.036) and high-grade tumour (HR 4.60; 95% CI 1.01–20.88; p = 0.048) are associated with an elevated odds of tumour recurrence. In multivariate Cox-regression analysis, there was no significant difference between C-HT and BCG in the odds of recurrence (p = 0.054). There were no differences in progression between C-HT and BCG.

Conclusion: C-HT is not as effective treatment as BCG in high-risk NMIBC patients who are BCG-naive. Although, there were no significant difference in the odds of recurrence, recurrence-free interval is significantly improved by the administration of BCG.

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Published

2015-05-13

How to Cite

Ekin, R. G., Akarken, I., Zorlu, F., Tarhan, H., Kucuk, U., Yildirim Ekin, Z., & Divrik, R. T. (2015). Intravesical bacillus Calmette-Guérin versus chemohyperthermia for high-risk non-muscle-invasive bladder cancer. Canadian Urological Association Journal, 9(5-6), E278–83. https://doi.org/10.5489/cuaj.2708

Issue

Vol. 9 No. 5-6 (2015): CUAJ May

Section

Original Research

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