Association of Increased Age With Decreased Response to Intravesical Instillation of Bacille Calmette-Guérin in Patients With High-Risk Non-Muscle Invasive Bladder Cancer: Retrospective Multi-Institute Results From the Japanese Urological Oncology Research Group JUOG-UC-1901-BCG.
Journal
Urology
ISSN: 1527-9995
Titre abrégé: Urology
Pays: United States
ID NLM: 0366151
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
16
02
2022
revised:
09
04
2022
accepted:
30
05
2022
pubmed:
15
6
2022
medline:
28
9
2022
entrez:
14
6
2022
Statut:
ppublish
Résumé
To compare the therapeutic effect of Bacille Calmette-Guérin (BCG) intravesical instillation in older and younger patients with high-risk non-muscle-invasive bladder cancer. The comparison was performed with propensity score matching (PSM) without terminating the death of the older patients using relatively large-scale retrospective data from multiple institutes in Japan. Overall, 3283 patients diagnosed with non-muscle-invasive bladder cancer treated with intravesical BCG instillation during 2000-2018 in 31 institutes were examined; 1437 and 602 patients with high-grade T1 and Tis tumors were divided into those aged ≥75 and <75 years. Multivariate analysis using the Fine-Gray competing risks regression model before PSM and survival analysis using the cumulative incidence method after PSM were performed. In the pre-PSM series of high-grade T1 tumors, age ≥75 years was an independent prognostic factor for both recurrence and progression in multivariate analysis (P = .015 and P = .013). In the pre-PSM series with Tis tumor, no variables to predict recurrence and progression was found. In the post-PSM series of 870 high-grade T1 tumors, cumulative probability of recurrence after BCG intravesical instillation were significantly higher in patients aged ≥75 years than in those aged <75 years (P = .008). The frequency of discontinuation of BCG instillation in patients aged ≥75 years with high-grade T1 and Tis was not significantly different from those in patients aged <75 years (P = .564 and P = .869). The cumulative probability of recurrence after intravesical BCG instillation was significantly higher in older than in younger patients with high-grade T1 bladder cancer.
Identifiants
pubmed: 35700751
pii: S0090-4295(22)00455-1
doi: 10.1016/j.urology.2022.05.034
pii:
doi:
Substances chimiques
Adjuvants, Immunologic
0
BCG Vaccine
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
158-164Commentaires et corrections
Type : CommentIn
Informations de copyright
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