Should patients with non-muscle-invasive bladder cancer discontinue fibrin clot inhibitors during bacille Calmette–Guérin?

Niyati Lobo, Patrick J. Hensley, Kelly K. Bree, Graciela M. Nogueras-Gonzalez, Neema Navai, Colin P. Dinney, Ashish M. Kamat

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To determine the impact of fibrin clot inhibitor (FCI) use on oncological outcomes in a large contemporary cohort of patients with non-muscle-invasive bladder cancer (NMIBC) treated with adequate bacille Calmette–Guérin (BCG). Patients and Methods: We performed an Institutional Review Board-approved review of patients with NMIBC treated with adequate intravesical BCG, at our institution between 2000 and 2018. FCI use at the time of BCG therapy was recorded for each patient. Patients were stratified according to use of FCI medication. Recurrence- and progression-free survival were analysed using Kaplan–Meier methods and Cox proportional hazard models. Results: Overall, 226 of 526 patients (43.0%) used a FCI: aspirin (205), clopidogrel (38), warfarin (18) and novel oral anticoagulant (NOAC; seven). The use of FCIs did not adversely affect either recurrence- or progression-free survival (P = 0.385 and P = 0.131, respectively). These results did not change when the impact of aspirin, clopidogrel or warfarin/NOAC use on recurrence and progression was evaluated separately. On multivariate analysis, FCI use was neither associated with tumour recurrence nor progression. Conclusion: The use of FCIs was not associated with adverse oncological outcomes in a large contemporary cohort of patients receiving adequate intravesical BCG for NMIBC. Based on these results, FCIs may be safely continued during BCG immunotherapy.

Original languageEnglish (US)
Pages (from-to)463-469
Number of pages7
JournalBJU international
Volume130
Issue number4
DOIs
StatePublished - Oct 2022

Keywords

  • #BladderCancer
  • #blcsm
  • #Urology
  • #uroonc
  • aspirin
  • bacille Calmette–Guérin
  • bladder cancer
  • clopidogrel
  • fibrin clot inhibitor
  • novel oral anticoagulant
  • warfarin

ASJC Scopus subject areas

  • Urology

MD Anderson CCSG core facilities

  • Biostatistics Resource Group

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