A Retrospective Follow-up Study on the Effects of Different Intravesical Treatments on Recurrence Control and Quality of Life in Patients With Non-Muscle-Invasive Bladder Cancer After Transurethral Resection of Bladder Tumour.

BACKGROUND

This study aimed to compare the mid-to long-term effects of pirarubicin chemotherapy and Bacillus Calmette-Guérin (BCG) immunotherapy on recurrence control, bladder function and health-related quality of life in patients with non muscle-invasive bladder cancer (NMIBC) after transurethral resection of bladder tumour (TURBT).

METHODS

This retrospective cohort study comprised 126 patients with NMIBC who underwent TURBT followed by intravesical therapy between January 2018 and December 2023. Patients received either pirarubicin (n = 68) or BCG (n = 58). Propensity score matching was performed to reduce baseline imbalance, yielding 48 matched patients in each group. Recurrence outcomes, recurrence-free survival (RFS), bladder function parameters, quality-of-life scores and adverse events were compared.

RESULTS

After matching,the recurrence rate was lower in the BCG group than in the pirarubicin group (18.75% vs 37.50%, p = 0.041). Time to first recurrence was longer with BCG than with pirarubicin (28.47 ± 8.31 vs 20.96 ± 7.84 months, p = 0.016), and Kaplan-Meier analysis showed improved RFS (median RFS: 45 [34-56] vs 31 [22-40] months; log-rank p = 0.011). At 12 months,the BCG group had lower post-void residual urine volume, higher maximum urinary flow rate,higher European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) global health and functional scores and lower symptom and Quality of Life Questionnaire-Bladder Cancer Module 30 (QLQ-BLM30) urinary symptom scores than the pirarubicin group (all p < 0.05). Subgroup analysis showed that the benefit of BCG was evident in patients with high-grade tumours.No severe treatment-related adverse events occurred in either group.

CONCLUSIONS

In patients with NMIBC after TURBT, intravesical BCG was associated with better recurrence control and more favourable mid-to long-term functional and quality-of-life outcomes than pirarubicin, particularly in high-grade disease.