Back to 2025 Abstracts
BCG EFFICACY AND DISEASE SURVIVAL ARE UNAFFECTED BY PRIOR PELVIC RADIATION IN HIGH-GRADE T1 BLADDER CANCER PATIENTS
Richard Glebocki, ScB, Raymond Che, MPH, Borivoj Golijanin, MD, Jack Mulcrone, BS, Sari Khaleel, MD, Dragan Golijanin, MD.
The Minimally Invasive Urology Institute at the Miriam Hospital, Brown University Health, Legoretta Cancer Center, Warren Alpert Medical School of Brown University, Providence, RI, USA.
BACKGROUND: BCG is the standard-of-care management for most high-grade T1 (HGT1) bladder cancer (BC), with response rates of over 50%. We asked whether pelvic radiation (pRT), a known risk factor for BC, predicted worse BCG response or disease survival in HGT1 patients.
METHODS: A retrospective review of an institutional cohort of patients diagnosed with HGT1 following TURBT between 2011-2021, comparing them by pRT history. Odds ratios (ORs) for recurrence (any grade) following induction BCG (iBCG) and HG recurrence after adequate BCG (adeqBCG, iBCGx2 or iBCG + ≥1 maintenance BCG) were calculated. Cox Multivariable Regression (MVR) was used to estimate hazard ratios (HRs) for overall and cancer-specific survival (OS, CSS), adjusting for age, pRT, carcinoma in situ, variant histology, focality, and tumor size. All analyses were performed using Stata 16.1.
RESULTS: Of 207 patients, 128 (61.8%) received iBCG, with 86/128 (67.2%) receiving adeqBCG. pRT patients had higher rates of any- and HG-recurrence post iBCG or adeqBCG, respectively, but this difference was not statistically significant (OR 2.21 [95% CI 0.74-6.61], p=0.154; OR 2.60 [95% CI 0.64-10.53], p=0.181, respectively; Table 1). pRT predicted worse OS (HR 2.02 [95% CI 1.04-3.94], p=0.039) in our age-adjusted model, with similar findings noted in our disease-specific model (HR 2.35 [95% CI 1.21-4.57], p=0.011). pRT was not associated with differences in CSS.
CONCLUSIONS: Pelvic radiation, despite being a known BC risk factor, is not associated with differences in recurrence of any grade after iBCG or HG recurrence after adeqBCG. However, pRT is associated with worse outcomes for OS. Our findings can guide counseling for patients diagnosed with HGT1 BC with a history of pRT.
Back to 2025 Abstracts
