Availability and Patterns of Intravesical BCG Instillations

Urol J. 2017 Nov 4;14(6):5068-5070. doi: 10.22037/uj.v14i6.3781.

Abstract

Purpose: Intravesical BCG instillations improve recurrence free survival in patients with non-muscle-invasive bladder cancer (NMIBC).

Methods: This is a national survey study, covering 223 urological centres, aimed at reliable identification of BCG availability and implemented treatment patterns.

Results: Response rate was 93.7%. BCG was used in 56.5% of urological departments. Another 22.7% referred patients to other hospitals for instillations, while 20.8% did not recommend BCG at all. The most common indications for BCG instillations were as follows: T1 tumours (88.5%), carcinoma in situ (83.6%) and high grade tumours (73.8%). Maintenance therapy was routinely abandoned in 16.4% of centres or was scheduled for <1 year, 1 year, 3 years and 1-3 years in 6.6%, 19.7%, 21.3% and 31.2% of centres, respectively. Continuation of BCGdespite treatment failure in carcinoma in situ cases was considered in 21.3% of departments.

Conclusion: Our findings indicate that BCG is underused, while patterns of maintenance and follow-up are suboptimal.

MeSH terms

  • Adjuvants, Immunologic / administration & dosage
  • Adjuvants, Immunologic / supply & distribution
  • Adjuvants, Immunologic / therapeutic use*
  • Administration, Intravesical
  • BCG Vaccine / administration & dosage
  • BCG Vaccine / supply & distribution
  • BCG Vaccine / therapeutic use*
  • Carcinoma in Situ / drug therapy*
  • Drug Administration Schedule
  • Humans
  • Maintenance Chemotherapy / statistics & numerical data
  • Poland
  • Practice Patterns, Physicians'
  • Referral and Consultation
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / pathology*

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine