Predictors of BCG Therapy Complications in Non-Muscle-Invasive Bladder Cancer: A Clavien-Dindo-Based Study

Area of Science:

• Urology
• Oncology
• Clinical Research

Background:

• Intravesical Bacillus Calmette-Guérin (BCG) is a standard adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC).
• BCG therapy offers oncological benefits but can cause local and systemic adverse events.
• The Clavien-Dindo classification system is used to grade complications.

Purpose of the Study:

• To evaluate the clinical significance of BCG-related complications.
• To assess the impact of complications on treatment continuation.
• To analyze risk factors for BCG-related adverse events.

Main Methods:

• Retrospective study of 694 bladder cancer patients treated with intravesical BCG (2004-2024).
• Adverse events were classified using the Clavien-Dindo system.
• Multivariate logistic regression identified predictors of complications.

Main Results:

• 17.6% of patients experienced BCG-related complications, mostly low-grade.
• Severe complications were infrequent.
• Increasing age (OR: 1.055) and high tumor grade (OR: 2.473) independently predicted complications.

Conclusions:

• Intravesical BCG therapy is generally safe and well-tolerated for NMIBC.
• Advanced age and high tumor grade are significant risk factors for BCG complications.
• Individualized management and careful patient selection are crucial for optimizing BCG therapy outcomes.