PD18-09 INCREASED BACILLUS CALMETTE-GUÉRIN TREATMENT INTENSITY ASSOCIATED WITH IMPROVED OUTCOMES IN ELDERLY PATIENTS WITH NON–MUSCLE-INVASIVE BLADDER CANCER

INTRODUCTION AND OBJECTIVES:Intravesical Bacillus Calmette-Guerin (BCG) is standard of care for intermediate- and high-risk non-muscle-invasive bladder cancer (NMIBC), but real-world use is unclear. We characterized BCG treatment patterns and outcomes associated with treatment intensity.METHODS:In this retrospective study, we identified NMIBC patients (pts) ≥ 66 y diagnosed 2000-2012 (follow-up through 2014) from the US Surveillance, Epidemiology and End Results (SEER)-Medicare database. NMIBC risk was defined per SEER (see Table). BCG claims were characterized as induction or maintenance. Adequate BCG was defined by ≥ 1 induction (≥ 5 instillations) and ≥ 1 maintenance (≥ 2 instillations) course; otherwise, treatment was considered inadequate. Exploratory landmark survival analyses at 6, 12, and 18 months (mo) using multivariate Cox models assessed associations between BCG treatment intensity and recurrence, progression, and cancer-specific and overall mortality by risk group. Recurrence and progression ...