Maintenance versus non-maintenance intravesical Bacillus Calmette-Guerin instillation for non-muscle invasive bladder cancer: A systematic review and meta-analysis of randomized clinical trials

Induction BCG followed by maintenance BCG instillation after TUR, compared with induction BCG along, can reduce the risk ratios of tumor recurrence and tumor progression, and prolong RFS. However, these results with a lower level of evidence should be treated with caution. The optimal maintenance schedule has yet to be determined and a large multi-institutional study in intermediate- and high-risk patients is also needed to determine the optimal maintenance schedule.