Guidelines debate in favour of BCG maintenance

Audience participation was an integral part of the Guidelines-dedicated Thematic Session 3 where the outcomes of pro and contra debates were revealed through voting. During the session Profs. Richard Sylvester (Brussels, BE) and George Thalmann (Berne, CH) discussed their views on BCG maintenance.

Prior to the debate, the audience was asked about their use of BCG, showing that 74% of the participants treat their patients with the drug. 12% reported they do not use it because of the side effects of the treatment.

After the presentations in which Sylvester demonstrated that BCG maintenance significantly reduces the risk of recurrence or cancer-related death and Thalmann questioned the treatment because of its severe side effects and the variable quality of TURBT preceding it, there was another round of voting.

It revealed that 29% of the voters would start using BCG maintenance after induction. Despite their opposing views during the presentation, Sylvester and Thalmann presented joint recommendations.

There remains a great need for additional, randomized studies, it is essential to perform a good TURBT before starting BCG treatment, and toxicity should be taken into account.