Analysis of age influence on oncological results and toxicity of BCG immunotherapy in non-muscle invasive bladder cancer

World J Urol. 2020 Dec;38(12):3177-3182. doi: 10.1007/s00345-020-03130-1. Epub 2020 Feb 18.

Abstract

Purpose: The aim of this study was to analyse the influence of age on the treatment outcome and toxicity in patients with T1HG non-muscle invasive bladder cancers treated with BCG immunotherapy.

Methods: Data from 637 patients with primary T1HG bladder cancer who were treated between 1986 and 2016 in two academic centres were retrospectively reviewed. Median follow-up was 57 months. Patients were divided into two groups: younger (< 70 years old) and older (≥ 70 years old). Additional analyses in subgroups of older (> 75 and > 80) patients were performed. Log-rank test, Cox regression analysis, and propensity score matching were performed to compare the groups.

Results: There were 389 patients below and 248 patients above or equal 70 years old. Recurrence-free, progression-free, and cancer-specific survival rates did not differ significantly between younger and older patients. Recurrence-free survival for younger and older patients were 55.4% vs 52.9%, progression-free survival 75.9% vs 76.6%, and cancer-specific survival were 87.5% vs 89.9% (all p > 0.05). Differences in the oldest subgroups also did not reach statistical significance. In both regression analysis and propensity score matching, no statistically significant associations of age with any of analysed end-points were found. Finally, there were no statistically significant differences between younger and older group in terms of moderate and severe complications occurrence (47.6% vs. 44.5%; p > 0.05) CONCLUSIONS: It was shown that increasing age was not associated with BCG immunotherapy oncological outcomes, or with BCG toxicity in T1HG non-muscle invasive bladder cancer.

Keywords: Age; BCG; Bladder cancer; Progression; Recurrence.

Publication types

  • Multicenter Study

MeSH terms

  • Adjuvants, Immunologic / adverse effects
  • Adjuvants, Immunologic / therapeutic use*
  • Age Factors
  • Aged
  • BCG Vaccine / adverse effects
  • BCG Vaccine / therapeutic use*
  • Female
  • Humans
  • Immunotherapy
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / therapy*

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine