Symptoms of Bacillus Calmette-Guerin Cystitis in Bladder Cancer Patients according to Tuberculosis Sequelae by Chest Radiography

Abstract

Purpose: Bacillus Calmette-Guerin (BCG) vaccination has been administered to most infants at birth in Korea; however, tuberculosis (TB) remains extant. TB can leave sequelae on chest radiography according to the immune response of the host. We investigated the symptoms of cystitis after intravesica instillations in bladder cancer, depending on the TB sequelae on chest radiography. Materials and Methods: One hundred forty-two patients with non-muscle invasive bladder cancer (NMIBC) underwent transurethral resection and intravesical BCG therapy for bladder cancer. Patients received a BCG induction course-with or without a maintenance course-and were divided into the two groups: Group A, which included patients with visible sequelae of TB on chest radiography (n=31) and group B, which included patients without visible sequelae of TB (n=111). Cystitis symptoms of BCG intravesical therapy were compared between the two groups. The recurrence and progression rates of bladder cancer were also analyzed. Results: The overall rate of cystitis symptoms was 32.3% (10/31) in group A and 33.3% (37/111) in group B. One patient in group A and three in group B did not complete the treatment course due to severe cystitis symptoms (p=0.876). Pyuria was reported when cystitis symptoms occurred in 80% (8/10) in group A and 56.8% (21/37) in group B. The recurrence and progression rates were not different between the two groups. Conclusions: Our results show that there was no significant difference of cystitis symptoms in accordance with the presence of TB sequelae in chest radiography when BCG instravesical therapy for NMIBC was performed.