Non-maintenance intravesical Bacillus Calmette–Guérin induction therapy with eight doses in patients with high- or highest-risk non-muscle invasive bladder cancer: a retrospective non-randomized comparative study

Autor: Makito Miyake, Kota Iida, Nobutaka Nishimura, Tatsuki Miyamoto, Kiyohide Fujimoto, Ryotaro Tomida, Kazumasa Matsumoto, Kazuyuki Numakura, Junichi Inokuchi, Shuichi Morizane, Takahiro Yoneyama, Yoshiaki Matsumura, Takashige Abe, Masaharu Inoue, Takeshi Yamada, Naoki Terada, Shuya Hirao, Motohide Uemura, Yuto Matsushita, Rikiya Taoka, Takashi Kobayashi, Takahiro Kojima, Yoshiyuki Matsui, Hiroshi Kitamura, Hiroyuki Nishiyama, on behalf of the Japanese Urological Oncology Group
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021)
Druh dokumentu: article
ISSN: 1471-2407
DOI: 10.1186/s12885-021-07966-7
Popis: Abstract Background To explore possible solutions to overcome chronic Bacillus Calmette–Guérin (BCG) shortage affecting seriously the management of non-muscle invasive bladder cancer (NMIBC) in Europe and throughout the world, we investigated whether non-maintenance eight-dose induction BCG (iBCG) was comparable to six-dose iBCG plus maintenance BCG (mBCG). Methods This observational study evaluated 2669 patients with high- or highest-risk NMIBC who treated with iBCG with or without mBCG during 2000–2019. The patients were classified into five groups according to treatment pattern: 874 (33%) received non-maintenance six-dose iBCG (Group A), 405 (15%) received six-dose iBCG plus mBCG (Group B), 1189 (44%) received non-maintenance seven−/eight-dose iBCG (Group C), 60 (2.2%) received seven−/eight-dose iBCG plus mBCG, and 141 (5.3%) received only ≤5-dose iBCG. Recurrence-free survival (RFS), progression-free survival, and cancer-specific survival were estimated and compared using Kaplan–Meier analysis and the log-rank test, respectively. Propensity score-based one-to-one matching was performed using a multivariable logistic regression model based on covariates to obtain balanced groups. To eliminate possible immortal bias, 6-, 12-, 18-, and 24-month conditional landmark analyses of RFS were performed. Results RFS comparison confirmed that mBCG yielded significant benefit following six-dose iBCG (Group B) in recurrence risk reduction compared to iBCG alone (groups A and C) before (P
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