Efficacy and quality of life evaluation of intravesical instillation of Nocardia rubra cell wall skeleton versus bacille Calmette-Guérin after surgery for non-muscle invasive bladder cancer： a retrospective study based on 2-year clinical follow-up

Abstract:

Objective To investigate the effect of intravesical infusion of Nocardia rubra cell wall skeleton（N-CWS） versus bacille Calmette-Guérin（BCG） on the treatment outcome and quality of life of patients with non-muscle invasive bladder cancer（NMIBC）.Methods A total of 86 patients with intermediate- to high-risk NMIBC who were admitted to the urology department of Sichuan Provincial People's Hospital from April 2016 to April 2021 were enrolled，and all the patients underwent surgical treatment and had complete clinical and follow-up data. According to the drug used for intravesical infusion，the patients were divided into N-CWS group（n=41） and BCG group（n=45）. After two years of follow-up，the two groups were compared in terms of quality of life，clinical outcome，and adverse reactions.Results Compared with the BCG group，the N-CWS group had lower 6-month recurrence rate（4.88% vs. 6.67%，χ²=0.125，P=0.723），1-year recurrence rate（9.76% vs. 17.78%，χ²=1.150，P=0.284），and 2-year recurrence rate（21.95% vs. 28.89%，χ²=3.268，P=0.071）. Compared with the BCG group at 6 months after intravesical infusion，the N-CWS group had significantly higher role function，emotional function，and overall function（P<0.05） and significantly lower scores of pain，urinary system symptoms，and problems caused by treatment（P<0.05）. At 1 year after intravesical infusion，compared with the BCG group，the N-CWS group had significantly higher role function，emotional function，and overall function（P<0.05） and significantly lower scores of pain，urinary system symptoms，and problems caused by treatment（P<0.05）. At 2 years after intravesical infusion，the N-CWS group had a significantly higher emotional function than the BCG group（P<0.05），and there were no significant differences in the other scores between the two groups. Compared with the BCG group，the N-CWS group had significantly lower incidence rates of the adverse events such as urinary tract irritation，hematuria，joint pain，and pyrexia（P<0.05）.Conclusion N-CWS has a comparable clinical effect to BCG in the intravesical infusion treatment of NMIBC after surgery and can effectively improve quality of life with a favorable safety profile，and therefore，it holds promise for clinical application.