The Korean Journal of Urological Oncology 2014;12(2):65-70.
Published online August 30, 2014.
Long Term Result of Modified 6+3 Bacillus Calmette-Guerin Maintenance Therapy for Non-muscle-invasive Bladder Cancer in Korea: Comparison of 6-week Therapy
Pil Moon Kang , Won Ik Seo , Jae Il Chung
Department of Urology, Busan Paik Hospital, InJe University, Busan, Korea
Correspondence:  Jae Il Chung
We report our experience with modified 6+3 maintenance BCG therapy compared with a 6-week induction course over the past 10 years and its effects on recurrence and progression. Materials and Methods: Between January 2001 and June 2012, a total of 181 patients treated with NMIBC underwent TUR and intravesical BCG. BCG was administered over a 6-week course in 88 patients, and was administered for six weeks followed by three weekly instillations at 3, 6, 9, 12, 18, 24, and 36 months (modified 6+3 regimen) in 93 patients. The recurrence rate, time to recurrence, and progression rate were assessed and analyzed. Results: A total of 30 of 181 patients were ineligible. Seventy-three patients in the 6-week induction group and seventy-eight patients in maintenance group were eligible. Median follow-up was 37.4 months in the maintenance group and 32.9 months in the 6-week course group. The estimated overall recurrence rate and median recurrence-free survival were 21.8% (17/78) and 23.4 months (95% confidence interval [CI] 7-84) in the maintenance group and 35.6% (26/73) and 21.5 months (6-80) in the 6-week course group (log rank p=0.002), respectively. Estimated median times for progression-free survival were 44.0 months (95% CI 7-84) in the maintenance group and 25.7 months (14-41) in the 6-week course group (log rank p=0.0815). The overall rates of adverse effects were 27.9% (26/93) in the maintenance group and 25.0% (22/88) in the 6-week course group. Conclusions: Compared to the standard 6-week course, maintenance BCG immunotherapy was beneficial for preventing recurrence in patients with non-muscle-invasive bladder cancer. (Korean J Urol Oncol 2014;12:65-70)
Key Words: Bladder cancer, Calmette-Guerin Bacillus, Maintenance

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