학술논문
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
Document Type
article
Author
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
Source
BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021)
Subject
Language
English
ISSN
1471-2407
Abstract
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