title: Influence of the true number of Bacillus Calmette-Guérin instillations on the prognosis of non-muscle invasive bladder tumors.
abstract: OBJECTIVE
  To analyze if the true number of BCG instillations applied in non-muscle invasive bladder tumors has any influence on their prognosis as well as other tumor and clinical characteristics: age, sex, different protocols, BCG dose, whether primary or recurrent, solitary or multiple, tumor size G3 or Cis.
  
  
  METHODS
  A total of 324 high grade NMIBC (15 TaG3, 184 T1G3, 125 Cis) out of 1491 cases included in the CUETO database were analyzed. Following 6 post transurethral resection (RTU) BCG instillations, the patients were scheduled to receive one instillation every two weeks (3-6 times), for a total of 9-12 instillations. One third of the dose (27 mg) (112 cases) or total dose of 81 mg (212 cases). Mean follow-up was 59.6 months. Statistical Analysis: Kaplan-Meier, Cox-regression (uni-multivariate).
  
  
  RESULTS
  A higher level of recurrence (p = 0.032) and progression (P = .013) risk as well as worse Ca-specific survival (P = .005) were obtained if there were fewer than 12 instillations with the Kaplan-Meier and Cox-regression multivariate analysis. A 27 mg (P = .008) dosage and being a female (P < .001) were independent factors for a higher recurrence risk, but not for progression or Ca-specific survival. The remaining characteristics studied were not statistically significant.
  
  
  CONCLUSIONS
  In accordance with the results obtained, we can conclude that the number of BCG instillations applied has some influence on the outcome of high grade NMIBC. The optimum number of instillations as well as their time of application must still be determined. A dose of 27 mg and being a female are predictive factors of recurrence.
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla (HUMV), Santander, España. Electronic address: josepm117@gmail.com.
authors: J A
authors: JA
authors: Portillo
authors: Servicio de Bioestadística, Hospital La Paz, Madrid, España.
authors: R
authors: R
authors: Madero
authors: Servicio de Urología, Instituto Valenciano de Oncología (IVO), Valencia, España.
authors: E
authors: E
authors: Solsona
authors: Servicio de Urología, Hospital Central de Asturias, Universidad de Oviedo, Oviedo, España.
authors: J M
authors: JM
authors: Fernandez
authors: Servicio de Urología, Hospital Infanta Sofía, Madrid, España.
authors: L
authors: L
authors: Martínez-Piñeiro
authors: Servicio de Urologia, Fundacion Puigvert, Barcelona, España.
authors: J
authors: J
authors: Palou
authors: Servicio de Urología, Hospital Virgen del Camino, Pamplona, España.
authors: M
authors: M
authors: Montesino
authors: Servicio de Urología, Hospital La Luz, Madrid, España.
authors: J A
authors: JA
authors: Martínez-Piñeiro
authors: Servicio de Urología, Hospital Basurto, Bilbao, España.
authors: M
authors: M
authors: Unda
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects*; D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine
keywords: Bacillus Calmette-Guérin; Bacilo de Calmette-Guérin; Carcinoma de células transicionales no músculo-infiltrantes; Dose; Dosis; Non-muscle invasive bladder cancer; Number of instillations; Número de instilaciones