Non-muscle invasive bladder cancer (NMBIC) is high-risk, high-grade carcinoma. Patients receive bacillus Calmette–Guérin (BCG) as standard care. The low-dose Tokyo strain is used in intravesical maintenance therapy(MT). This study investigates the efficacy and safety of MT in NMBID patients who had transurethral resection surgery.

The retrospective study at a single center reviewed 78 patients’ data. They were diagnosed with high-risk or intermediate NMBIC. One group with 38 patients received MT for six years between 2012 to 2018. The other group of 40 patients had intravesical therapy (IT) alone. Statistical analysis compared the adverse effects and recurrence-free survival (RFS) in the two groups. BCG was instilled once a week as IT for six weeks. Then, once every two weeks for a total of 20 instills over three years.

The MT patients had significantly better RFS, as per Kaplan-Meier analysis, than the IT-alone group. The three year RFS for the MT group was 89.5%, while the IT group was 65%. Multivariate analysis associated the MT group with reduced risk of recurrence. Only 1 MT patient had shown progression.

The BCG Tokyo strain displayed acceptable safety and efficacy in MT patients. It has the potential to prevent the recurrence of bladder cancer.