Association of patients' sex with treatment outcomes after intravesical bacillus Calmette-Guérin immunotherapy for T1G3/HG bladder cancer
D'Andrea, David (Medical University of Vienna. Department of Urology)
Soria, F. (University of the Studies of Turin. Division of Urology.)
Grotenhuis, A.J. (Radboud University Medical Centre. Department of Urology)
Cha, E.K. (Memorial Sloan Kettering Cancer Center Department of Urology)
Malats, Núria (Centro Nacional de Investigaciones Oncológicas)
Di Stasi, S. (Policlinico Tor Vergata-University of Rome. Department of Urology.)
Joniau, Steven (University Hospitals Leuven. Department of Urology.)
Cai, T. (Santa Chiara Hospital. Department of Urology)
van Rhijn, B.W.G. (The Netherlands Cancer Institute (Amsterdam, Països Baixos))
Irani, J. (University of Poitiers. Department of Urology.)
Karnes, J. (Mayo Clinic. Department of Urology)
Varkarakis, J. (University of Athens. Department of Urology)
Baniel, J. (Rabin Medical Centre. Department of Urology)
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
Babjuk, Marek (University of Praha. Department of Urology.)
Spahn, M. (University Hospital of Wuerzburg. Department of Urology)
Ardelt, P. (Universitätsklinik Freiburg. Department of Urology)
Colombo, Renzo (Università Vita Salute. Department of Urology)
Serretta, V. (University of Palermo. Department of Surgical)
Dalbagni, G. (Memorial Sloan Kettering Cancer Center. Department of Urology)
Gontero, Paolo (Università degli Studi di Torino)
Bartoletti, R. (University of Pisa. Department of Translational Research and New Technologies)
Larré, S. (CHU de Reims. Department of Urology)
Malmström, Per-Uno (Uppsala University (Uppsala, Suècia))
Sylvester, R. (European Association of Urology Non-Muscle Invasive Bladder Cancer Guidelines Panel)
Shariat, S.F. (European Association of Urology Research Foundation)

Date:	2021
Abstract:	Purpose: To investigate the association of patients' sex with recurrence and disease progression in patients treated with intravesical bacillus Calmette-Guérin (BCG) for T1G3/HG urinary bladder cancer (UBC). Materials and methods: We analyzed the data of 2635 patients treated with adjuvant intravesical BCG for T1 UBC between 1984 and 2019. We accounted for missing data using multiple imputations and adjusted for covariate imbalance between males and females using inverse probability weighting (IPW). Crude and IPW-adjusted Cox regression analyses were used to estimate the hazard ratios (HR) with their 95% confidence intervals (CI) for the association of patients' sex with HG-recurrence and disease progression. Results: A total of 2170 (82%) males and 465 (18%) females were available for analysis. Overall, 1090 (50%) males and 244 (52%) females experienced recurrence, and 391 (18%) males and 104 (22%) females experienced disease progression. On IPW-adjusted Cox regression analyses, female sex was associated with disease progression (HR 1. 25, 95%CI 1. 01-1. 56, p = 0. 04) but not with recurrence (HR 1. 06, 95%CI 0. 92-1. 22, p = 0. 41). A total of 1056 patients were treated with adequate BCG. In these patients, on IPW-adjusted Cox regression analyses, patients' sex was not associated with recurrence (HR 0. 99, 95%CI 0. 80-1. 24, p = 0. 96), HG-recurrence (HR 1. 00, 95%CI 0. 78-1. 29, p = 0. 99) or disease progression (HR 1. 12, 95%CI 0. 78-1. 60, p = 0. 55). Conclusion: Our analysis generates the hypothesis of a differential response to BCG between males and females if not adequately treated. Further studies should focus on sex-based differences in innate and adaptive immune system and their association with BCG response.
Note:	Altres ajuts: Medizinische Universität Wien.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Bladder cancer ; BCG ; Response ; Age ; Progression ; Recurrence
Published in:	World Journal of Urology, Vol. 39 Núm. 9 (september 2021) , p. 3337-3344, ISSN 1433-8726

DOI: 10.1007/s00345-021-03653-1
PMID: 33713162

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