Using grade of tumor recurrence after BCG to guide further therapy.

523Background: Tumors that recur after BCG therapy are considered to be high risk and patients are often recommended to undergo radical cystectomy (RC). However, the nuances associated with the grade of tumor recurrence after BCG treatment are not well understood. We aimed to characterize the pattern of bladder cancer progression and cancer specific survival (CSS) in patients with recurrences dichotomized by low grade versus high grade after intravesical BCG treatment. Furthermore, to assess the safety of continued bladder sparing therapy in these patients. Methods: We performed an IRB approved review of our bladder cancer database. Overall, 146 NMIBC patients were found to have tumor recurrence after induction BCG with/without maintenance therapy, 38 with LG and 108 with HG tumors. Baseline clinicopathologic characteristics including age, gender, primary tumor grade, stage, size, multiplicity and concurrent CIS were collected and compared between the two groups. The primary endpoint was PFS, with progres...