Low-dose or -number of BCG in non-muscle invasive bladder cancer: updated systematic review and meta-analysis

Author:

Kawada Tatsushi12ORCID,Yanagisawa Takafumi13ORCID,Bekku Kensuke12ORCID,Laukhtina Ekaterina14ORCID,Deimling Markus von15ORCID,Majdoub Mohammed16,Chlosta Marcin17ORCID,Pradere Benjamin18ORCID,Babjuk Marko19,Gontero Paolo10ORCID,Moschini Marco11ORCID,Araki Motoo2ORCID,Shariat Shahrokh F14121314ORCID

Affiliation:

1. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090, Vienna, Austria

2. Department of Urology, Okayama University Graduate School of Medicine, Dentistry & Pharmaceutical Sciences, Okayama, 700-8530, Japan

3. Department of Urology, The Jikei University School of Medicine, Tokyo, 105-8471, Japan

4. Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119435, Russia

5. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, 20251, Germany

6. Department of Urology, Hillel Yaffe Medical Center, Hadera, 3820302, Israel

7. Department of Urology, Jagiellonian University Medical College, Cracow, 31-008, Poland

8. Department of Urology UROSUD, La Croix Du Sud Hospital, Quint Fonsegrives, 31130, France

9. Department of Urology, Second Faculty of Medicine of Charles University, University Hospital Motol, Prague, 150 06, Czech Republic

10. Urology Unit, Department of Surgical Sciences, University of Turin, Turin, 10124, Italy

11. Department of Urology, IRCCS San Raffaele Hospital & Vita-Salute San Raffaele University, Milan, 20132, Italy

12. Division of Urology, Department of Special Surgery, The University of Jordan, Amman, 11942, Jordan

13. Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA

14. Department of Urology, Second Faculty of Medicine, Charles University, Prague, 150 06, Czech Republic

Abstract

Aim: We aimed to review the evidence of reducing the dose or number of BCG instillations in non-muscle invasive bladder cancer (NMIBC) patients. Material & methods: A literature search was done according to Preferred Reporting Items for Meta-Analyses statement. Results: Overall, 15 and 13 studies were eligible for qualitative and quantitative synthesis, respectively. In patients with NMIBC, lowering either the dose or number of BCG instillations increases the risk of recurrence, but not the risk of progression. Lowering the dose of BCG decreases the risk of adverse events compared with standard-dose BCG. Conclusion: Standard-dose and -number of BCG is preferred for NMIBC patients based on oncologic efficacy; however, low-dose BCG could be considered in selected patients who suffer from significant adverse events.

Publisher

Future Medicine Ltd

Subject

Oncology,Immunology,Immunology and Allergy

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