Radical cystectomy compared to intravesical BCG immunotherapy for high-risk non-muscle invasive bladder cancer – is there a long-term survival difference? A Swedish nationwide analysis

Wang, Eugen Y-H.; Larsson, Ulf; Gårdmark, Truls; Malmström, Per‐Uno

doi:10.1080/21681805.2020.1851763

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…For these reasons, authorities such as the EAU and AUA recommend that patients with NMIBC who meet the criteria for secondary TURBT should undergo re-TURBT 2 to 6 weeks after the initial TURBT ( 4 , 17 ). Nevertheless, the choice of treatment for patients at high risk with NMIBC with a high-grade T1 pathological result, whether BCG instillation or RC treatment, remains a point of contention in contemporary clinical practices ( 5 – 7 ). Our study conducted a long-term follow-up and compared the differences in OS and PFS among patients who underwent BCG instillation or RC treatment.…”

Section: Discussionmentioning

confidence: 99%

“…( 6 ) on 188 patients with high-risk NMIBC echoed these results. A large-scale multi-center study from Sweden followed up 3862 patients with high-risk NMIBC who received BCG instillation treatment and 687 who received RC treatment and found that the 5-year PFS in the BCG group was superior to that in the RC group (87% vs. 71%) ( 5 ). Hautmann et al.…”

Section: Discussionmentioning

confidence: 99%

“…However, for patients whose pathology results from re-TURBT are still in the high-grade T1 stage, the recommended course of action is either Bacillus Calmette-Gueŕin (BCG) instillation therapy or radical cystectomy (RC) (4). However, the superiority of either of these treatment options remains controversial (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

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Comparative efficacy of Bacillus Calmette–Guérin instillation and radical cystectomy treatments for high-risk non-muscle-invasive urothelial cancer classified as high-grade T1 in initial and repeat transurethral resection of bladder tumor

Zhen,

Hao,

Yanhang

et al. 2024

Front. Oncol.

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ObjectiveTo compare the differential therapeutic effects of Bacillus Calmette-Guérin (BCG) instillation and radical cystectomy (RC) for high-risk non-muscle–invasive urothelial cancer (NMIBC) classified as high-grade T1 in initial and repeat transurethral resection of bladder tumors (TURBT) and to construct a prediction model.MethodsWe retrospectively analyzed the clinical data of patients with malignant bladder tumors treated at the First Affiliated Hospital of Soochow University from January 2016 to December 2017 and compared the differences in 1-year, 2-year, 3-year, 5-year, and comprehensive overall survival (OS) and progression-free survival (PFS) between BCG instillation treatment and RC treatment. Survival curves were drawn to show differences in OS and PFS between the two groups. Concurrently, univariate and multivariate COX analyses were performed to identify risk factors affecting OS and PFS, and a nomogram was created.ResultsIn total, 146 patients were included in the study, of whom 97 and 49 were in the BCG and RC groups, respectively. No statistical differences were observed in the 1- and 2-year OS and PFS between the two groups, whereas significant statistical differences were found in the 3-year, 5-year, and comprehensive OS and PFS. Survival curves also confirmed the statistical differences in OS and PFS between the BCG and RC groups. Multivariate COX analysis revealed that the treatment method, concomitant satellite lesions, and albumin-to-alkaline phosphatase ratio (AAPR) were independent risk factors affecting OS and PFS. The nomogram that was further plotted showed good predictive ability for OS and PFS.ConclusionFor patients who exhibit high-level T1 pathology after both initial and repeat TURBT, especially those with low AAPR, and concomitant satellite lesions, choosing RC as a treatment method offers a better prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparative efficacy of Bacillus Calmette–Guérin instillation and radical cystectomy treatments for high-risk non-muscle-invasive urothelial cancer classified as high-grade T1 in initial and repeat transurethral resection of bladder tumor

Zhen,

Hao,

Yanhang

et al. 2024

Front. Oncol.

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“…RARC is being performed more widely and CQRs faciliate the comparison of RARC outcomes against that of ORC. Several countries including England, Sweden, Italy, Austria, and the Czech Republic have established national cystectomy CQRs 46–50 . Furthermore, in 2017, a multicenter, multinational RARC registry was set up in Asia and Australia.…”

Section: Cqrsmentioning

confidence: 99%

Centralization and prospective audit of cystectomy are necessary: a commentary on the case for centralization, supported by a contemporary series utilizing the ANZUP cystectomy database

Viswambaram

McCombie

Hawks

et al. 2022

Asia-Pac J Clncl Oncology

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Bladder cancer (BC) outcomes are unacceptably poor. In Australia, BC survival is actually deteriorating. There is an urgent need to improve outcomes in BC patients, which requires a multipronged approach. One area deserving closer scrutiny is radical cystectomy. Audit is necessary to identify areas for improvement and without it, outcomes remain unknown. Evidence convincingly shows high‐volume surgeons and centers improve cystectomy outcomes including overall survival, yet centralization has still not occurred. The Australia and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group cystectomy database has been established to facilitate cystectomy audit in Australia and New Zealand. We present initial data from the ANZUP cystectomy database from a single high‐volume center, discuss the benefits of centralization and its challenges in the Asia‐Pacific context.

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The efficacy of sequential intravesical gemcitabine and docetaxel versus BCG for the treatment of European association of urology very-high risk non-muscle invasive bladder cancer

Abou Chakra,

Packiam,

McElree

et al. 2024

Urologic Oncology: Seminars and Original Investigations

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Radical cystectomy compared to intravesical BCG immunotherapy for high-risk non-muscle invasive bladder cancer – is there a long-term survival difference? A Swedish nationwide analysis

Cited by 7 publications

References 15 publications

Comparative efficacy of Bacillus Calmette–Guérin instillation and radical cystectomy treatments for high-risk non-muscle-invasive urothelial cancer classified as high-grade T1 in initial and repeat transurethral resection of bladder tumor

Comparative efficacy of Bacillus Calmette–Guérin instillation and radical cystectomy treatments for high-risk non-muscle-invasive urothelial cancer classified as high-grade T1 in initial and repeat transurethral resection of bladder tumor

Centralization and prospective audit of cystectomy are necessary: a commentary on the case for centralization, supported by a contemporary series utilizing the ANZUP cystectomy database

The efficacy of sequential intravesical gemcitabine and docetaxel versus BCG for the treatment of European association of urology very-high risk non-muscle invasive bladder cancer

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