Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China.
Cancer Med. 2023 Dec;12(23):21279-21286. doi: 10.1002/cam4.6707. Epub 2023 Nov 14.
There is no consensus regarding the best interval time between transurethral resection of a bladder tumor and Bacillus Calmette-Guerin (BCG) perfusion. This study was to explore whether the interval time has an impact on the prognosis and adverse effects.
We retrospectively reviewed the clinical data of patients who received BCG intravesical perfusion at Sun Yat-sen University Cancer Center (SYSUCC) from September 2015 to October 2021. Recurrence-free survival (RFS) and progression-free survival were the primary endpoints. Cox regression was used to explore independent predictors. The association between interval time and adverse effect grade was detected by logistic regression. Propensity score matching (PSM) was performed.
A total of 403 patients were enrolled, the median interval time was 24 days (6-163 days), and the follow-up was 28 months (7-82 months). Eighty-eight (20.9%) patients relapsed, and 40 patients (10.0%) suffered progression. The multivariate Cox regression analysis confirmed that interval time was an independent predictor of RFS (p = 0.017). Notably, when the interval time was less than or equal to 26 days, there was a trend toward better RFS, PSM resulted in 65 matched pairs in each group, and Kaplan-Meier analysis showed that there was a significant difference in RFS between groups (p = 0.009). The logistic regression analysis showed that there was no correlation between interval time and adverse effects and their grades (p > 0.05).
We considered that the first BCG perfusion could be performed within 2-4 weeks after surgery.
经尿道膀胱肿瘤切除术与卡介苗（BCG）灌注之间的最佳间隔时间尚无共识。本研究旨在探讨间隔时间是否会对预后和不良反应产生影响。
我们回顾性分析了 2015 年 9 月至 2021 年 10 月中山大学肿瘤防治中心（SYSUCC）接受 BCG 膀胱内灌注治疗的患者的临床资料。无复发生存（RFS）和无进展生存（PFS）是主要终点。Cox 回归用于探讨独立预测因素。Logistic 回归检测间隔时间与不良反应等级之间的关系。采用倾向评分匹配（PSM）。
共纳入 403 例患者，中位间隔时间为 24 天（6-163 天），随访时间为 28 个月（7-82 个月）。88 例（20.9%）患者复发，40 例（10.0%）患者进展。多因素 Cox 回归分析证实间隔时间是 RFS 的独立预测因素（p=0.017）。值得注意的是，当间隔时间小于或等于 26 天时，RFS 有改善的趋势。PSM 后每组有 65 对匹配，Kaplan-Meier 分析显示两组间 RFS 差异有统计学意义（p=0.009）。Logistic 回归分析显示间隔时间与不良反应及其等级之间无相关性（p>0.05）。
我们认为术后 2-4 周内可进行首次 BCG 灌注。
