Abstract
Introduction
Prostate radiotherapy is associated with worse oncologic outcomes in patients with
bladder cancer. The underlying mechanism is incompletely understood but is thought
to be related to an altered microenvironment promoting tumorigenesis. However, there
is a gap in the literature regarding how the effect of BCG varies according to prior
radiotherapy in patients with non–muscle invasive bladder cancer (NMIBC). In this
context, we sought to evaluate oncologic outcomes in NMIBC patients who have previously
undergone prostate radiotherapy compared to patients with no prior history of pelvic
radiotherapy.
Methods
This is a retrospective cohort study that includes all patients who received intravesical
for NMIBC at our institution from 2001 to 2019. Patients were stratified into 3 cohorts:
prior radiotherapy (RT), radical prostatectomy (RP), and no prostate cancer (No PCa).
The outcomes of interest were recurrence at 1-year, progression to muscle-invasive
bladder cancer (MIBC), and progression to metastatic disease. Comparisons were also
made between cohorts with respect to elapsed time from radiation therapy. Wilcoxon
rank-sum test was used for comparing continuous variables, while χ2 and Fischer's exact tests were used to examine categorical variables.
Results
In 199 total patients who underwent BCG for NMIBC, 23 had a prior history of prostate
radiotherapy treatment, while 17 underwent prior radical prostatectomy. Overall, 41.2%
of patients had recurrence at 1 year. There was no difference in the number of induction
or maintenance BCG administrations received between the cohorts within the first year.
There was no significant difference in recurrence at 1 year between the 3 cohorts
(P = .56). There was also no difference in progression to MIBC or progression to metastatic
disease with P = .50 and 0.89, respectively.
Conclusion
The risk of recurrence after induction BCG treatment for high-grade NMIBC does not
vary according to prior radiation treatment for prostate cancer.
Keywords
Abbreviations:
NMIBC (non–muscle invasive bladder cancer), MIBC (muscle invasive bladder cancer), BCG (Bacillus Calmette-Guerin), RT (radiotherapy), RP (radical prostatectomy), PCa (prostate cancer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 13, 2022
Accepted:
June 11,
2022
Received in revised form:
June 8,
2022
Received:
December 3,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
