Intravesical Bacillus Calmette-Guerin in Ta and T1 Bladder Cancer

Area of Science:

• Urology
• Oncology
• Immunotherapy

Background:

• Superficial bladder cancer management often involves transurethral resection (TUR).
• Tumor recurrence is a significant concern following TUR for bladder cancer.
• Intravesical Bacillus Calmette-Guerin (BCG) is a therapeutic option to prevent recurrence.

Purpose of the Study:

• To compare tumor recurrence rates between transurethral resection (TUR) alone and TUR combined with intravesical Bacillus Calmette-Guerin (BCG).
• To evaluate the efficacy of intravesical BCG in preventing tumor recurrence in patients with superficial bladder cancer.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched multiple databases including Cochrane, Medline, EMBASE, Cancerlit, Healthstar, and DARE.
• Included trials involving patients with Ta and T1 bladder cancer at medium or high risk of recurrence.

Main Results:

• Six randomized trials with 585 patients were analyzed.
• BCG plus TUR significantly reduced 12-month disease recurrence compared to TUR alone (odds ratio 0.30).
• Common BCG toxicities included cystitis, hematuria, fever, and urinary frequency, with no reported deaths.

Conclusions:

• Intravesical BCG immunotherapy following TUR provides a significant benefit in delaying tumor recurrence for patients with medium/high risk Ta or T1 bladder cancer.
• BCG is an effective adjuvant therapy to TUR for reducing superficial bladder cancer recurrence.