JMIR Publications

ABSTRACT

Background:

Bacillus Calmette-Guérin (BCG) is currently the most clinically effective intravesical treatment for non–muscle-invasive bladder cancer (NMIBC), particularly for patients with high-risk NMIBC such as those with carcinoma in-situ (CIS). BCG treatments could be optimized to improve patient safety and conserve supply by predicting BCG efficacy with tumor characteristics or clinicopathological criteria.

Objective:

To assess the ability of specific clinicopathological criteria to predict tumor recurrence in patients with NMIBC who received BCG along various treatment timelines.

Methods:

A total of 1331 patients (Stage Ta, T1, or CIS) who underwent transurethral resection of a bladder tumor (TUR) between 2006 and 2017 were included. Univariate analysis including laboratory tests (e.g. complete blood panels, creatinine levels, Hemoglobin A1c levels) within 180 days post-BCG therapy initiation, medications, and clinical and demographic variables to assess their ability to predict NMIBC recurrence was completed. This was followed by multivariate regression that included the elements of Club Urológico Español de Tratamiento Oncológico (CUETO) and variables that were significant predictors of recurrence in univariate analysis.

Results:

BCG was administered to 183 intermediate- or high-risk patients, and 76 (41.5%) experienced disease recurrence. Abnormal neutrophil-to-lymphocyte ratio measured within 180 days post-induction BCG was a significant predictor (p<0.05) of future cancer recurrence and was a stronger predictor than CUETO or the individual variables included in CUETO via multivariate analysis.

Conclusions:

Abnormal neutrophil-to-lymphocyte ratio within 180 days following BCG is predictive of recurrence and could be a suggestive for additional or alternative interventions. Clinical Trial: N/A