Association of patients' sex with treatment outcomes after intravesical bacillus Calmette-Guerin immunotherapy for T1G3/HG bladder cancer

Autor: Per-Uno Malmström, Núria Malats, Vincenzo Serretta, Renzo Colombo, Richard Sylvester, Savino M. Di Stasi, Bas W.G. van Rhijn, Shahrokh F. Shariat, Paolo Gontero, Anne J. Grotenhuis, Marek Babjuk, Riccardo Bartoletti, Steven Joniau, Jack Baniel, T. Tony Cai, Jeffrey Karnes, Martin Spahn, Joan Palou, J. Varkarakis, Francesco Soria, J. Irani, Peter U. Ardelt, David D'Andrea, Guido Dalbagni, Eugene K. Cha, Stéphane Larré
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Nephrology
Male
medicine.medical_treatment
Treatment outcome
030232 urology & nephrology
Gastroenterology
0302 clinical medicine
Immunologic
Recurrence
Urologi och njurmedicin
BCG
Progression
Intravesical
Hazard ratio
Bladder cancer
Response
Urology & Nephrology
Middle Aged
Administration
Intravesical
Treatment Outcome
030220 oncology & carcinogenesis
Administration
BCG Vaccine
Female
Original Article
Immunotherapy
Adjuvant
Life Sciences & Biomedicine
Age
medicine.medical_specialty
Urology
03 medical and health sciences
Sex Factors
Adjuvants
Immunologic
Internal medicine
medicine
Humans
Urology and Nephrology
Adjuvants
Aged
Retrospective Studies
Neoplasm Grading
Urinary Bladder Neoplasms
Science & Technology
Proportional hazards model
business.industry
medicine.disease
Confidence interval
Settore MED/24
business
Zdroj: World Journal of Urology
WORLD JOURNAL OF UROLOGY
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 0724-4983
Popis: Purpose To investigate the association of patients’ sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette–Guérin (BCG) for T1G3/HG urinary bladder cancer (UBC). Materials and methods We analyzed the data of 2635 patients treated with adjuvant intravesical BCG for T1 UBC between 1984 and 2019. We accounted for missing data using multiple imputations and adjusted for covariate imbalance between males and females using inverse probability weighting (IPW). Crude and IPW-adjusted Cox regression analyses were used to estimate the hazard ratios (HR) with their 95% confidence intervals (CI) for the association of patients’ sex with HG-recurrence and disease progression. Results A total of 2170 (82%) males and 465 (18%) females were available for analysis. Overall, 1090 (50%) males and 244 (52%) females experienced recurrence, and 391 (18%) males and 104 (22%) females experienced disease progression. On IPW-adjusted Cox regression analyses, female sex was associated with disease progression (HR 1.25, 95%CI 1.01–1.56, p = 0.04) but not with recurrence (HR 1.06, 95%CI 0.92–1.22, p = 0.41). A total of 1056 patients were treated with adequate BCG. In these patients, on IPW-adjusted Cox regression analyses, patients’ sex was not associated with recurrence (HR 0.99, 95%CI 0.80–1.24, p = 0.96), HG-recurrence (HR 1.00, 95%CI 0.78–1.29, p = 0.99) or disease progression (HR 1.12, 95%CI 0.78–1.60, p = 0.55). Conclusion Our analysis generates the hypothesis of a differential response to BCG between males and females if not adequately treated. Further studies should focus on sex-based differences in innate and adaptive immune system and their association with BCG response.
Databáze: OpenAIRE
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