Comparison of intravesical Bacillus Calmette-Guérin and chemohyperthermia with mitomycin C in with high-risk non–muscle-invasive bladder cancer: a critical assesment focusing on the quality of life and adverse events


Ilki F. Y., Bülbül E., Topçu Y. K., Cinar O., Kocabıyık C., BEDİR S.

BMC Urology, cilt.26, sa.1, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1186/s12894-025-02040-x
  • Dergi Adı: BMC Urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
  • Anahtar Kelimeler: Non-muscle invasive bladder cancer, Bacillus Calmette-Gu & eacute;& eacute;rin, Chemohyperthermia, Mitomycin C, Intravesical therapy
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Objective: This study aimed to compare the effects of intravesical Bacillus Calmette-Guérin (BCG) and chemohyperthermia (CHT) with mitomycin C (MMC) therapy on symptom burden, recurrence, and quality of life in patients with high-risk non–muscle-invasive bladder cancer (NMIBC). Methods: A total of 116 male patients with high-risk NMIBC were included, comprising 52 treated with BCG and 64 treated with CHT-MMC. Symptom severity was evaluated using the International Prostate Symptom Score (IPSS) and the Overactive Bladder Questionnaire (OAB-V8) before and after treatment. Post-treatment adverse events such as dysuria, hematuria, and pollakiuria were recorded. Quality of life was assessed using the Short Form-12 (SF-12) Health Survey, including the physical (PCS) and mental component summary (MCS) scores. Recurrence rates were monitored during a 24-month follow-up period. Results: Following treatment, symptom scores (IPSS and OAB-V8) were significantly worsened in the BCG group compared to the CHT-MMC group (p < 0.01). Dysuria occurred in 84.6% of patients in the BCG group and in 46.2% of those in the CHT-MMC group (p = 0.054). Hematuria was observed in 43.8% and 12.5% of patients in the BCG and CHT-MMC groups, respectively (p = 0.095). The mean PCS score was significantly lower in the BCG group than in the CHT-MMC group (43.9 ± 11.0 vs. 54.9 ± 6.3, p = 0.008), whereas there was no statistically significant difference in MCS scores between the two groups (p = 0.145). Disease recurrence was detected in 22 of 52 patients (42.3%) in the BCG group and in 38 of 64 patients (59.4%) in the CHT-MMC group (p = 0.467). Conclusion: Intravesical chemohyperthermia with mitomycin C (CHT-MMC) was associated with a more favorable symptom profile and superior physical quality of life compared to BCG, while no statistically significant difference was observed in recurrence rates. These results indicate that intravesical CHT-MMC may represent a well-tolerated and effective therapeutic alternative for high-risk NMIBC patients who are intolerant to or have contraindications for BCG therapy.