Influence of the true number of Bacillus Calmette-Guerin instillations on the prognosis of non-muscle invasive bladder tumors
Por:
Portillo, JA, Madero, R, Solsona, E, Fernandez, JM, Martinez-Pineiro, L, Palou, J, Montesino, M, Martinez-Pineiro, JA, Unda, M
Publicada:
1 jun 2014
Resumen:
Objectives: To analyze if the true number of BCG instillations applied in non-muscle invasive bladder tumors has any influence on their prognosis as well as other tumor and clinical characteristics: age, sex, different protocols, BCG dose, whether primary or recurrent, solitary or multiple, tumor size G3 or Cis.
Patients and methods: A total of 324 high grade NMIBC (15 TaG3, 184 T1 G3, 125 Cis) out of 1491 cases included in the CUETO database were analyzed. Following 6 post transurethral resection (RTU) BCG instillations, the patients were scheduled to receive one instillation every two weeks (3-6 times), for a total of 9-12 instillations. One third of the dose (27 mg) (112 cases) or total dose of 81 mg (212 cases). Mean follow-up was 59.6 months. Statistical Analysis: Kaplan-Meier, Cox-regression (uni-multivariate).
Results: A higher level of recurrence (p = 0.032) and progression (P=.013) risk as well as worse Ca-specific survival (P=.005) were obtained if there were fewer than 12 instillations with the Kaplan-Meier and Cox-regression multivariate analysis. A 27 mg (P=.008) dosage and being a female (P<.001) were independent factors for a higher recurrence risk, but not for progression or Ca-specific survival. The remaining characteristics studied were not statistically significant.
Conclusions: In accordance with the results obtained, we can conclude that the number of BCG instillations applied has some influence on the outcome of high grade NMIBC. The optimum number of instillations as well as their time of application must still be determined. A dose of 27 mg and being a female are predictive factors of recurrence. (c) 2013 AEU. Published by Elsevier Espana, S.L. All rights reserved.
Filiaciones:
Portillo, JA:
HUMV, Serv Urol, Santander, Spain
Madero, R:
Hosp La Paz, Serv Bioestadist, Madrid, Spain
Solsona, E:
IVO, Serv Urol, Valencia, Spain
Fernandez, JM:
Univ Oviedo, Hosp Cent Asturias, Serv Urol, E-33080 Oviedo, Spain
Martinez-Pineiro, L:
Hosp Infanta Sofia, Serv Urol, Madrid, Spain
Palou, J:
Fdn Puigvert, Serv Urol, Barcelona, Spain
Montesino, M:
Hosp Virgen Camino, Serv Urol, Pamplona, Spain
Martinez-Pineiro, JA:
Hosp La Luz, Serv Urol, Madrid, Spain
Unda, M:
Hosp Basurto, Serv Urol, Bilbao, Spain
|