Objective: This study compares the efficacy and side effect profiles of Bacillus Calmette-Guerin (BCG) and Mitomycin-C (MMC) in managing Non-Muscle Invasive Bladder Cancer (NMIBC), focusing on recurrence-free survival (RFS), progression-free survival (PFS) and adverse events. Methods: This retrospective sectional study was conducted at Department of Urology, Peoples University of Medical and Health Sciences, Nawab Shah from September 2021 to April 2022. It included 200 histologically confirmed NMIBC patients, treated with BCG (n=100) or MMC (n=100) after transurethral resection of bladder tumor (TURBT). RFS, PFS, and adverse events were analyzed over a 12-month follow-up.
Results: BCG demonstrated significantly higher RFS (85% vs. 78%, p=0.041) and PFS (92% vs. 88%, p=0.032) compared to MMC. Adverse events were more frequent in the BCG group, including cystitis (30% vs. 18%, p=0.032) and fever (15% vs. 5%, p=0.002). Logistic regression identified high-grade tumors (OR: 2.34, p=0.001) and tumor size >3 cm (OR: 1.78, p=0.021) as predictors of recurrence.
Conclusion: BCG was more effective in preventing recurrence and progression in NMIBC but was associated with higher toxicity. MMC remains a viable alternative for intermediate-risk patients and those intolerant to BCG.
Key words: Non-muscle invasive bladder cancer, Bacillus Calmette-Guérin, Mitomycin-C, intravesical therapy.
|
