title: Bacillus Calmette-Guerin therapy after the second transurethral resection significantly decreases recurrence in patients with new onset high-grade T1 bladder cancer.
abstract: BACKGROUND
  The purpose of this study was to assess the efficacy of Bacillus Calmette-Guerin (BCG) therapy after a second transurethral resection (TUR) in new onset high-grade T1 bladder cancer.
  
  
  METHODS
  From January 2008 to September 2013, 207 patients with new onset high-grade T1 bladder cancer after an initial TUR were treated at our university and at affiliated hospitals. Residual cancer rate, intravesical recurrence-free survival (RFS), and risk factors for intravesical recurrence were analyzed.
  
  
  RESULTS
  Among a total of 207 patients, 42 patients were treated with BCG therapy following a second TUR (group 1), 23 were treated with second TUR alone (group 2), 72 were treated with BCG alone (group 3), and 70 were treated without a second TUR or BCG. The median patients' age was 72.0 years, and the median follow-up period was 33.5 months. The second TUR revealed that 34 patients (52 %) had residual cancer. Between groups 1 and 2 and groups 1 and 3, the differences in RFS were statistically significant (p = 0.002 and 0.045, respectively). In addition, BCG therapy was the most significant factor to predict RFS after the second TUR. Among the 31 patients whose pathology of the second TUR was pT0, only 1 of 12 patients (8 %) in group 1 and 11 of 19 patients (58 %) in group 2 had a recurrence.
  
  
  CONCLUSIONS
  BCG instillation following a second TUR decreases intravesical recurrence, even if the pathology of the second TUR is pT0.
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. ikeitarou1009@gmail.com.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Iida
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. rx-nike@hotmail.co.jp.|Department of Urology, Daido Hospital, Aichi, Japan. rx-nike@hotmail.co.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Naiki
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. n-kawai@med.nagoya-cu.ac.jp.
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Kawai
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. to_etani@yahoo.co.jp.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Etani
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. ryo@med.nagoya-cu.ac.jp.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ando
authors.affiliation: Department of Urology, Nagoya City East Medical Center, Aichi, Japan. urouroyokun@yahoo.co.jp.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ikegami
authors.affiliation: Department of Urology, Anjo Kosei Hospital, Aichi, Japan. hiko2546@kosei.anjo.aichi.jp.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Urology, Kainan Hospital, Aichi, Japan. 479659@kainan.jaaikosei.or.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kubota
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. a-okada@med.nagoya-cu.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okada
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. urokk@med.nagoya-cu.ac.jp.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
authors.affiliation: Department of Nephro-Urology, Nagoya City University, Graduate School of Medical Sciences, Kawasumi 1, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. yasui@med.nagoya-cu.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000628:therapy*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000276:Adjuvants, Immunologic; D001500:BCG Vaccine