Treatment patterns and prognosis in patients with Bacillus Calmette–Guérin-exposed high-risk non-muscle invasive bladder cancer: a real-world data analysis

Nobutaka Nishimura, Makito Miyake*, Kota Iida, Tatsuki Miyamoto, Ryotaro Tomida, Kazuyuki Numakura, Junichi Inokuchi, Takahiro Yoneyama, Eijiro Okajima, Shugo Yajima, Hitoshi Masuda, Naoki Terada, Rikiya Taoka, Takashi Kobayashi, Takahiro Kojima, Yoshiyuki Matsui, Naotaka Nishiyama, Hiroshi Kitamura, Hiroyuki Nishiyama, Kiyohide Fujimoto

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

1 被引用数 (Scopus)

抄録

Purpose: The International Bladder Cancer Group designated the subgroup that is resistant to Bacillus Calmette–Guérin (BCG) but does not meet the criteria for BCG-unresponsive NMIBC as “BCG-exposed high-risk NMIBC” to guide optimal trial design. We aimed to investigate the treatment patterns and prognoses of patients with BCG-exposed NMIBC. Methods: We conducted a retrospective chart review of 3283 patients who received intravesical BCG therapy for NMIBC at 14 participating institutions between January 2000 and December 2019. Patients meeting the criteria for BCG-exposed and BCG-unresponsive NMIBC, as defined by the Food and Drug Administration and International Bladder Cancer Group, were selected. To compare treatment patterns and outcomes, high-risk recurrence occurring more than 24 months after the last dose of BCG was defined as “BCG-treated NMIBC.” In addition, we compared prognoses between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Results: Of 3283 patients, 108 (3.3%), 150 (4.6%), and 391 (11.9%) were classified as having BCG-exposed, unresponsive, and treated NMIBC, respectively. BCG-exposed NMIBC demonstrated intermediate survival curves for intravesical recurrence-free and progression-free survival, falling between those of BCG-unresponsive and treated NMIBC. Among patients with BCG-exposed NMIBC, 48 (44.4%) received BCG rechallenge, which was the most commonly performed treatment, and 19 (17.6%) underwent early cystectomy. No significant differences were observed between BCG rechallenge and early cystectomy in patients with BCG-exposed NMIBC. Conclusions: The newly proposed definition of BCG-exposed NMIBC may serve as a valuable disease subgroup for distinguishing significant gray areas, except in cases of BCG-unresponsive NMIBC.

本文言語英語
論文番号185
ジャーナルWorld Journal of Urology
42
1
DOI
出版ステータス出版済み - 2024/12

ASJC Scopus 主題領域

  • 泌尿器学

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