Difference in recurrence frequencies of non-muscle-invasive-bladder tumors depending on optimal usage of intravesical immunotherapy of bacillus Calmette-Guérin

Radovan Milošević; Novak Milović; Predrag Aleksić; Miodrag Lazić; Snežana Cerović; Vladimir Bančević; Branko Košević; Predrag Marić; Aleksandar Spasić; Dejan Simić; Božidar Kovačević

doi:10.2298/4776

Radovan Milošević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Novak Milović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Predrag Aleksić Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Miodrag Lazić Department of Urology, Hospital Dr Dragiša Mišović, Belgrade, Serbia
Snežana Cerović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute for Pathology, Military Medical Academy, Belgrade, Serbia
Vladimir Bančević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Branko Košević Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Predrag Marić Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Aleksandar Spasić Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Dejan Simić Clinic of Urology, Military Medical Academy, Belgrade, Serbia
Božidar Kovačević Institute for Pathology, Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/4776

Keywords: urinary bladder, neoplasms, carcinoma in situ, immunotherapy, mycobacterium bovis, recurrence,

Abstract

Background/Aim. The therapy with intravesical instillation of bacillus Calmette-Guérin (BCG) after transurethral resection (TUR) of the tumor is the gold standard of treatment of non-muscle invasive bladder cancer (NMIBC). The aim of this study was to compare the frequencies of reccurence between a group of patients submitted to TUR + BCG therapy (group I) and a group of patients submitted only to TUR (group II). Methods. The patients with NMIBC, a total of 899, treated in our Institution from January 1, 2007 to March, 2013, were included in this study and divided into two groups: group I and group II. These two groups were divided into three subgroups: solitary first diagnosed tumor ≤ 3 cm (SFDGT), solitary first diagnosed tumor > 3 cm and multiple first diagnosed tumors (MFDGT), and recedive tumors (RCT). Statistical analysis was performed by using χ²-test and Kolmogorov-Smirnov test. Results: In the group I a total of 133 cases had reccurence contrary to 75 in the group II, making a statistically highly significant difference. Analysis of recurrences through the subgroups revealed: in the group I SFDGT recurrence occured in 27 of the cases vs 9 cases in the group II; in the group I MFDGT recurrence occured in 49 of the cases vs 31 in the group II (p < 0.001), and finally, in the group I RCT recurrence occured in 57 cases vs 35 cases in the group II (p < 0.001). Conclusion. The obtained results indicate no difference in the frequency of reccurence between the group I and group II regarding SFDGT, but a very high significant difference regarding those with MFDGT and RCT. These results should be taken into consideration in everyday clinical practise.

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