Delaying BCG immunotherapy onset after transurethral resection of non-muscle-invasive bladder cancer is associated with adverse survival outcomes.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Krajewski Wojciech, Moschini Marco, Chorbińska Joanna, Nowak Łukasz, Poletajew Sławomir, Tukiendorf Andrzej, Afferi Luca, Teoh Jeremy Yuen-Chun, Muilwijk Tim, Joniau Steven, Tafuri Alessandro, Antonelli Alessandro, Cianflone Francesco, Mari Andrea, Di Trapani Ettore, Hendricksen Kees, Alvarez-Maestro Mario, Rodríguez-Serrano Andrea, Simone Giuseppe, Zamboni Stefania, Simeone Claudio, Marconi Maria Cristina, Mastroianni Riccardo, Ploussard Guillaume, Laukhtina Ekaterina, Tully Karl, Kołodziej Anna, Krajewska Joanna, Piszczek Radosław, Xylinas Evanguelos, Zdrojowy Romuald, European Association of Urology—Young Academic Urologists (EAU-YAU): Urothelial carcinoma working group
Аннотация
MATERIALS AND METHODS: Data on 429 patients from 13 tertiary care centers with primary T1HG NMIBC treated with reTURB and maintenance BCG between 2001 and 2019 were retrospectively reviewed. Change-point regression was applied following Muggeo's approach. The population was divided into subgroups according to TTBCG, whereas the recurrence-free survival (RFS) and progression-free survival (PFS) were estimated with log-rank tests. Additionally, Cox regression analyses were performed. Due to differences in baseline patient characteristics, propensity-score-matched analysis (PSM) and inverse-probability weighting (IPW) were implemented.
RESULTS: The median TTBCG was 95 days (interquartile range (IQR): 71-127). The change-point regression analysis revealed a gradually increasing risk of recurrence with growing TTBCG. The risk of tumor progression gradually increased until a TTBCG of approximately 18 weeks. When the study population was divided into two subgroups (time intervals: ≤ 101 and > 101 days), statistically significant differences were found for both RFS (p = 0.029) and PFS (p = 0.005). Furthermore, in patients with a viable tumor at reTURB, there were no differences in RFS and PFS. After both PSM and IPW, statistically significant differences were found for both RFS and PFS, with worse results for longer TTBCG.
CONCLUSION: This study shows that delaying BCG immunotherapy after TURB of T1HG NMIBC is associated with an increased risk of tumor recurrence and progression.