title: Are there time-period-related differences in the prophylactic effects of Bacille Calmette-Guerin intravesical instillation therapy in Japan?
abstract: OBJECTIVE
  The guidelines on indications for prophylactic use of Bacille Calmette-Guerin (BCG) against non- muscle-invasive bladder cancer (NMIBC) have changed over the years. In order to assess the impact on outcome, the present retrospective comparison of BCG efficacy by time period with Japanese patients was conducted.
  
  
  METHODS
  A total of 146 cases of NMIBC treated with BCG since February 1985 were retrospectively evaluated. All patients received 80 mg of BCG (Tokyo 172 strain) six to eight times a week for prophylactic use. Comparison was made among three historical groups (Group A: 1980's, 39 cases; Group B: 1990's, 61 cases; Group C: 2000's, 46 cases).
  
  
  RESULTS
  In total, recurrence was seen in 55 of the 146 cases (37.7%), and progression in 14 (9.6%), 1 patient dying of cancer. These overall results were similar to those outlined in previous reports. However, the outcomes of this time-period-based analysis indicated a tendency for a shorter time to recurrence in patients after 2000, although a log-rank test showed no significance (P=0.229). Seven of the cases featuring progression (i.e., half of all such cases) were among the 46 Group C patients (15.2%). Excluding these progressive cases, there was no significant difference among the remaining 132 patients in the three groups.
  
  
  CONCLUSIONS
  This study results revealed a tendency for a lower non-recurrence rate after 2000 in our series. This could stem from a number of factors, including changes in BCG indication criteria and the evolution of histopathological diagnostic criteria.
authors.affiliation: Department of Urology, JA Aichi Anjo Kosei Hospital, Anjo, Japan. hiko2546@sf.commufa.jp
authors.forename: Takehiko
authors.initials: T
authors.lastname: Okamura
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ando
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Akita
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iwase
authors.forename: Taku
authors.initials: T
authors.lastname: Naiki
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Kawai
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage*; D002291:Carcinoma, Papillary / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine