title: Recurrence and progression in nonmuscle invasive transitional cell carcinoma of urinary bladder treated with intravesical Bacillus Calmette-Guerin: A single center experience and analysis of prognostic factors.
abstract: BACKGROUND
  Intravesical Bacillus Calmette-Guerin (BCG) has been the standard of care for the prevention of nonmuscle invasive bladder cancer (NMIBC) recurrence following resection. Attempts to improve on the result by combining it with other agents have largely failed. This study addresses the result of BCG therapy in our patient population and compares the result with our combination BCG and interferon therapy published earlier.
  
  
  METHODS
  The medical records of patients diagnosed with NMIBC and treated with transurethral resection and intravesical BCG were reviewed. Univariate analysis was performed on most known prognostic factors. Results were compared to published data on the use of BCG and interferon from the same institution.
  
  
  RESULTS
  Thirty-one patients were identified. Median age was 66 (range 33-109), 80.6% were males. Fourteen patients (45%) had ≤ 3 tumors and 18 (58.1%) had T1 lesions. Four patients (12.9%) had Grade 3 tumors and 25 (80.6%) had Grade 2 tumors. One patient (3.2) had concurrent carcinoma in situ and 11 (35.5%) were treated upon initial diagnosis. At 5 years, the relapse-free survival was 61.3% (95% confidence interval (CI) 44.2-78.4%), progression-free survival was 85.6% (95% CI 73.3-97.9%), and overall survival was 93% (95% CI 84.1-100%). Comparison with the BCG and interferon data showed no significant difference.
  
  
  CONCLUSIONS
  The result of BCG therapy in our patient population is similar to western reported data. Efficacy of BCG alone is equal to BCG and interferon within our institution.
authors.affiliation: Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Shouki N
authors.initials: SN
authors.lastname: Bazarbashi
authors.affiliation: College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
authors.forename: Haya J
authors.initials: HJ
authors.lastname: Azouz
authors.affiliation: Department of Oncology, Gavle Hospital, Gävle, Sweden.
authors.forename: Amal H
authors.initials: AH
authors.lastname: Abu Sabaa
authors.affiliation: Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Ali H
authors.initials: AH
authors.lastname: Aljubran
authors.affiliation: Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Alzahrani
authors.affiliation: Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Alotaibi
keywords: Bacillus Calmette–Guerin; interferon; nonmuscle invasive bladder cancer; prognostic factors