Compared Efficacy of Adjuvant Intravesical BCG-TICE vs. BCG-RIVM for High-Risk Non-Muscle Invasive Bladder Cancer (NMIBC) : A Propensity Score Matched Analysis
Del Giudice, Francesco ![ORCID Identifier](/img/uab/orcid.ico)
(Stanford Medical Center. Department of Urology.)
Flammia, Rocco Simone ![ORCID Identifier](/img/uab/orcid.ico)
(Policlinico Umberto I Hospital. "Sapienza" Rome University. Department of Maternal-Infant and Urological Sciences)
Chung, Benjamin I. (Department of Urology. Stanford Medical Center)
Moschini, Marco (Department of Urology. Scientific Institute San Raffaele Hospital)
Pradere, Benjamin ![ORCID Identifier](/img/uab/orcid.ico)
(Medical University of Vienna)
Mari, Andrea ![ORCID Identifier](/img/uab/orcid.ico)
(Unit of Oncologic Minimally-Invasive Urology and Andrology. Department of Experimental and Clinical Medicine Careggi Hospital. University of Florence)
Soria, Francesco
(Urology Division. Department of Surgical Sciences. University of Studies of Torino)
Albisinni, Simone (Urology Department. Erasme Hospital. Université Libre de Bruxelles)
Krajewski, Wojciech (Department of Urology and Oncological Urology. Wrocław Medical University)
Szydełko, Tomasz (Department of Urology and Oncological Urology. Wrocław Medical University)
Laukhtina, Ekaterina
(Institute for Urology and Reproductive Health. Sechenov University)
D'Andrea, David
(Department of Urology. Medical University of Vienna)
Gallioli, Andrea
(Institut d'Investigació Biomèdica Sant Pau)
Mertens, Laura S. (Department of Urology. The Netherlands Cancer Institute)
Maggi, Martina
(Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Sciarra, Alessandro
(Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Salciccia, Stefano (Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Ferro, Matteo
(Department of Urology. European Institute of Oncology (IEO))
Scornajenghi, Carlo Maria (Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Asero, Vincenzo
(Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Cattarino, Susanna (Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Angelis, Mario De (Department of Urology. Scientific Institute San Raffaele Hospital)
Cacciamani, Giovanni E.
(University of Southern California)
Autorino, Riccardo
(Division of Urology. Department of Surgery. Virginia Commonwealth University)
Pandolfo, Savio Domenico
(Division of Urology. Department of Surgery. Virginia Commonwealth University)
Falagario, Ugo Giovanni (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
D'Altilia, Nicola (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Mancini, Vito
(Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Chirico, Marco (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Cinelli, Francesco (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Bettocchi, Carlo (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Cormio, Luigi (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Carrieri, Giuseppe (Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
De Berardinis, Ettore (Department of Maternal-Infant and Urological Sciences. Policlinico Umberto I Hospital. "Sapienza" Rome University)
Busetto, Gian Maria
(Department of Urology and Renal Transplantation. Policlinico Riuniti di Foggia. University of Foggia)
Date: |
2022 |
Abstract: |
Background: Intravesical immunotherapy with bacillus Calmette-Guerin (BCG) is the standard therapy for high-risk non-muscle invasive bladder cancer (NMIBC). The superiority of any BCG strain over another could not be demonstrated yet. Methods: Patients with NMIBCs underwent adjuvant induction ± maintenance schedule of intravesical immunotherapy with either BCG TICE or RIVM at two high-volume tertiary institutions. Only BCG-naïve patients and those treated with the same strain over the course of follow-up were included. One-to-one (1:1) propensity score matching (PSM) between the two cohorts was utilized to adjust for baseline demographic and tumor characteristics imbalances. Kaplan-Meier estimates and multivariable Cox regression models according to high-risk NMIBC prognostic factors were implemented to address survival differences between the strains. Sub-group analysis modeling of the influence of routine secondary resection (re-TUR) in the setting of the sole maintenance adjuvant schedule for the two strains was further performed. Results: 852 Ta-T1 NMIBCs (n = 719, 84. 4% on TICE; n = 133, 15. 6% on RIVM) with a median of 53 (24-77) months of follow-up were reviewed. After PSM, no differences at 5- years RFS, PFS, and CSS at both Kaplan-Meier and Cox regression analyses were detected for the whole cohort. In the sub-group setting of full adherence to European/American Urology Guidelines (EAU/NCCN), BCG TICE demonstrated longer 5-years RFS compared to RIVM (68% vs. 43%, p = 0. 008; HR: 0. 45 95% CI 0. 25-0. 81). Conclusion: When routinely performing re-TUR followed by a maintenance BCG schedule, TICE was superior to RIVM for RFS outcomes. However, no significant differences were detected for PFS and CSS, respectively. |
Rights: |
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Language: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Subject: |
Bladder cancer ;
Re-TUR ;
BCG strain ;
BCG-TICE ;
BCG-RIVM ;
Recurrence-free survival ;
Progression-free survival ;
Cancer-specific survival |
Published in: |
Cancers, Vol. 14 Núm. 4 (Februrary 2022) , p. 887, ISSN 2072-6694 |
DOI: 10.3390/cancers14040887
PMID: 35205635
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Record created 2023-07-06, last modified 2023-09-07