Compared Efficacy of Adjuvant Intravesical BCG-TICE vs. BCG-RIVM for High-Risk Non-Muscle Invasive Bladder Cancer (NMIBC): A Propensity Score Matched Analysis

Cancers

on behalf of European Association of Urology (EAU)—Young Academic Urologists (YAU) Urothelial Cancer Working Party¹  Alessandro Sciarra²  Ettore De Berardinis²  Martina Maggi²  Vincenzo Asero²  Rocco Simone Flammia²  Stefano Salciccia²  Susanna Cattarino²  Carlo Maria Scornajenghi²  Francesco Del Giudice²  Ugo Giovanni Falagario³  Wojciech Krajewski⁴  Tomasz Szydełko⁴  Giuseppe Carrieri⁵  Luigi Cormio⁵  Gian Maria Busetto⁵  Carlo Bettocchi⁵  Nicola D’Altilia⁵  Marco Chirico⁵  Francesco Cinelli⁵  Vito Mancini⁵  Ekaterina Laukhtina⁶  David D’Andrea⁶  Benjamin Pradere⁶  Marco Moschini⁷  Mario De Angelis⁷  Benjamin I. Chung⁸  Laura S. Mertens⁹  Savio Domenico Pandolfo^1,10  Riccardo Autorino^1,10  Matteo Ferro^1,11  Giovanni E. Cacciamani^1,12  Andrea Mari^1,13  Andrea Gallioli^1,14  Simone Albisinni^1,15  Francesco Soria^1,16 

[1] ;Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, “Sapienza” Rome University, 00185 Rome, Italy;Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, 80131 Naples, Italy;Department of Urology and Oncological Urology, Wrocław Medical University, 50-556 Wrocław, Poland;Department of Urology and Renal Transplantation, Policlinico Riuniti di Foggia, University of Foggia, 71122 Foggia, Italy;Department of Urology, Medical University of Vienna, 1090 Vienna, Austria;Department of Urology, San Raffaele Hospital and Scientific Institute, 20132 Milan, Italy;Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA;Department of Urology, The Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands;Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA;Division of Urology, European Institute of Oncology (IEO)-IRCCS, 20141 Milan, Italy;USC Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA;Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, 50134 Florence, Italy;Unit of Urology, Fundacio Puigvert, 08025 Barcelona, Spain;Urology Department, Erasme Hospital, Université Libre de Bruxelles, 1070 Brussels, Belgium;Urology Division, Department of Surgical Sciences, University of Studies of Torino, 10126 Turin, Italy;

关键词: bladder cancer;    re-TUR;    BCG strain;    BCG-TICE;    BCG-RIVM;    recurrence-free survival;   

DOI  :  10.3390/cancers14040887

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown