Outcomes of Patients with Bacillus Calmette-Guérin (BCG)-Unresponsive Non-Muscle Invasive Bladder Cancer as Defined by the U.S. Food and Drug Administration.
Non-muscle invasive bladder cancer
bacillus Calmette-Guérin
bladder conserving treatment
radical cystectomy
Journal
Bladder cancer (Amsterdam, Netherlands)
ISSN: 2352-3735
Titre abrégé: Bladder Cancer
Pays: Netherlands
ID NLM: 101668567
Informations de publication
Date de publication:
2022
2022
Historique:
received:
20
12
2021
accepted:
31
05
2022
medline:
15
9
2022
pubmed:
15
9
2022
entrez:
12
7
2024
Statut:
epublish
Résumé
Limited data are available on the outcomes of patients with non-muscle invasive bladder cancer (NMIBC) unresponsive to intravesical bacillus Calmette-Guérin (BCG), as defined by the United States Food and Drug Administration. To define the outcomes of patients with BCG-unresponsive NMIBC. This was a retrospective, single-institution observational cohort study. Records of patients managed at our institution for BCG-unresponsive NMIBC between 2005 and 2020 were reviewed and clinical outcomes evaluated. The study included 149 patients. Management was with initial radical cystectomy in 60 patients (40%) and initial bladder-sparing therapy (BST) in 89 patients (60%). Overall survival was greater among patients undergoing RC than BST (HR 1.83, 95% CI 1.04-3.22, Among patients who underwent initial BST for BCG-unresponsive NMIBC, rates of treatment failure were very high. Patients who underwent delayed cystectomy after ≥2 lines of BST had elevated rates of extravesical disease. Our observations emphasize the importance of recent and ongoing clinical trials in this clinical space.
Sections du résumé
BACKGROUND
BACKGROUND
Limited data are available on the outcomes of patients with non-muscle invasive bladder cancer (NMIBC) unresponsive to intravesical bacillus Calmette-Guérin (BCG), as defined by the United States Food and Drug Administration.
OBJECTIVE
OBJECTIVE
To define the outcomes of patients with BCG-unresponsive NMIBC.
METHODS
METHODS
This was a retrospective, single-institution observational cohort study. Records of patients managed at our institution for BCG-unresponsive NMIBC between 2005 and 2020 were reviewed and clinical outcomes evaluated.
RESULTS
RESULTS
The study included 149 patients. Management was with initial radical cystectomy in 60 patients (40%) and initial bladder-sparing therapy (BST) in 89 patients (60%). Overall survival was greater among patients undergoing RC than BST (HR 1.83, 95% CI 1.04-3.22,
CONCLUSION
CONCLUSIONS
Among patients who underwent initial BST for BCG-unresponsive NMIBC, rates of treatment failure were very high. Patients who underwent delayed cystectomy after ≥2 lines of BST had elevated rates of extravesical disease. Our observations emphasize the importance of recent and ongoing clinical trials in this clinical space.
Identifiants
pubmed: 38993682
doi: 10.3233/BLC-211657
pii: BLC211657
pmc: PMC11181681
doi:
Types de publication
Journal Article
Langues
eng
Pagination
303-314Informations de copyright
© 2022 – The authors. Published by IOS Press.
Déclaration de conflit d'intérêts
Y.L. is an Editorial Board Member of this journal but was not involved in the peer-review process nor had access to any information regarding its peer-review. Y.L. reports relationships with the following entities: Abbott, Abbvie, Ambu, AstraZeneca, BioCanCell, CAPs Medical, Cepheid, Cleveland Diagnostics, C2I Genomics, Fergene, Ferring Research, FKD, GenomeDx Biosciences, Hitachi, Karl Storz, MDxHealth, Merck, Nanorobotics, Nucleix, Pacific Edge, Photocure, Seattle Genetics, Stimit, Verity Pharmaceuticals, Vessi Medical, Virtuoso Surgical. J.M.H., G.S.C., A.T., K.N., V.M. and S.L.W. report no conflicts.