Affordable Access

Intravesical Instillation of Bacille Calmette-Guérin for Superficial Bladder Cancer: Cost-Effectiveness Analysis

Authors
Journal
Urology
0090-4295
Publisher
Elsevier
Publication Date
Volume
69
Issue
2
Identifiers
DOI: 10.1016/j.urology.2006.10.017
Keywords
  • Adult Urology
Disciplines
  • Biology
  • Economics
  • Medicine

Abstract

Objectives Frequent recurrence of superficial bladder cancer is a major problem that impairs patients’ quality of life. We studied the current treatment of superficial bladder cancer, including the economic aspects of intravesical instillation. Methods A total of 138 superficial bladder cancers were assessed. The tumor characteristics and treatments were investigated during a mean observation period of 86 months by univariate and multivariate analyses. The costs associated with intravesical instillation of bacille Calmette-Guérin (BCG) and its side effects were subjected to cost-effectiveness analysis. Results Tumor histologic examination revealed grade 1 in 21 lesions, grade 2 in 60 lesions, grade 3 in 40 lesions, and unclassified in 17 lesions. The pathologic stage was Stage Ta in 85 lesions, T1 in 47 lesions, and Tis in 6 lesions. Univariate and multivariate analyses showed that intravesical instillation of BCG was the most significant factor preventing recurrence, and intravesical chemotherapy had no impact on recurrence. The 5-year recurrence-free survival rate was 78% and 28% for tumors with and without BCG instillation, respectively. The cost-effectiveness ratio of BCG instillation was approximately $3900/5-yr recurrence-free period. Conclusions Our results have indicated that BCG is an effective adjuvant therapy after transurethral resection of superficial bladder cancer in the current medical environment.

There are no comments yet on this publication. Be the first to share your thoughts.